Ovarian cyst.pdfvbnmklloiiopiujojujhghjjhv

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1. Presented By
MD ASHIK BILLA BAIDYA
SAMPRIKTA NAYAK
RATNADIPA RUDRA PAL

2. CASE SCENERIO
A 36 Years old female patient came to an
OPD with a chief complain of pain abdomen
with irregular bleeding for 10 days.

3. History of Present illness-
Dull aching pain on lower abdomen for last 10 days.
Heaviness in lower abdomen
Irregular bleeding occur but there is no clots passed
during menstruation.
Painful constipation(Dyschezia) around the time of
period.
Dysuria(painful micturition) during the periods.
Menstrual History-LMP-01/10/22
Obstetric History-P(1+0) Viable, Normal Delivery & No
complication during child birth.
LCB(Last Child Birth)-4Yrs Back.
Past History-No history of any drug allergy, DM/HTN, Surgical
complications and any malignancy.
H/o contraception pill practice.

4. Examination-
General & Systemic examination-All within the normal
range. BMI-30.6
Abdominal examination-No scar mark. Evertedumbilicus.
A big lump on palpation which is mobile, smooth,
unilateral, slow growing.
Speculum examination-Normal cervix and vagina
Bimanual examination-Uterus-normal size, Retroverted,
consistency, mobility and tenderness.

5. Investigation Procedure-
USG-It shows-i) Right ovarian cyst ii) Left Adenexal
cyst-? Chocolate Cyst.
CECT-A large cyst measures 11.8 x 7.2 cm is seen
anterior to uterus probably left ovarian origin. It does
not show any solid enhancing component.
Relatively smaller sized cyst is seen in relation to right
ovary measuring 4 x 3.2 cm.
Tumor Marker-CA-125
Pregnancy Test-If +vetest, there be corpus luteumcyst
MRI

6. Provisional Diagnosis-It may be
“ADENEXAL CYST-LEFT OVARIAN CYST”
A collection of fluid filled sac or pocket within or on the
surface of an ovary.
It is shown as SuprapubicLump.

7. Differential Diagnosis-
Full Bladder
Fibroid
Pregnancy
Chocolate Cyst of Ovary
JUSTIFICATION-
Since the patient is seen after passing urine, then the
suprapubiclump is not full bladder.
The lump is mobile, soft, firm. If it is fibroid then it can
be hard, immobile.
The patient is not Amenorrheic,so that’s why she has
no chance of pregnancy
If pregnancy test is +veoccur, it may be ‘Corpus Luteum
Cyst’

8. TYPES OF OVARIAN CYST:
FUNCTIONAL OVARIAN CYST-1) FOLLICULAR CYST
2) CORPUS LUTEUM CYST
PATHOLOGICAL OVARIAN CYST-1) DERMOID CYSTS
2) CYSTADENOMAS
3) ENDOMETRIOMAS

10. Complication of these-
Torsion of the pedicle
Rupture
IntracysticHemorrhage
Infection
Infertility
Ovarian Cancer

11. Management & Treatment-
Treatment will depends upon the –a) nature of mass
b) age of women
Conservative Management-
It is Ideal for a patient-simple, unilateral and unilocular
ovarian cyst. low RMI-<8cm. Serum CA-125 Normal.
Such women are followed up with TVS at an interval of
4 months.
Hormonal Birth Control Pills
Analgesic-NSAIDS, Opiods.

12. Surgical Management-
Once the ovarian cysts diagnosed, the patient should be
admitted for operation as sooner the better.
GUIDELINES-
Incision
To inspect the nature of peritoneal fluid.
To deliver the tumor intact
To proceed
To cut the tumor and then inspect side for any
malignancy.
It is not prodentto bisect the contralateralovary, if it
looks normal.

13. LAPAROTOMYfollowed by removal of ovarian cyst is the
definitive surgery.

14. Post-operative diagnosis-
Vitals check
Urine Input & Output
Hemorrhagic cyst with clots
Findings-Normal right ovary, uterus and upper
abdomen.
After a laparoscopy, it may take some time to resume
its normal activity.

15. Post-operative complications-
1) Mild pain and discomfort in lower tummy
2) Small amount of Vaginal bleeding for upto48 hours.
3) Feeling tired for few days
Patient to be discharged with oral hydrations and
analgesia
Appointment for tracing histopathology after 6wks.
“Overall the Prognosis was Good”

16. THANK YOU