Mezenterik Kisti Taklit Eden Dev Over Kistine Mini-Phannensteil İnsizyon ile Yaklaşım

Year 2022, Volume: 19 Issue: 2, 1335 - 1338, 01.07.2022

Rabia Merve Palalıoglu , Aytakin Mahammadaliyeva Halil Erbıyık Murat Muhcu

https://doi.org/10.38136/jgon.872388

Abstract

Tüm vücut dokularında kistler oluşabilir, ancak overler dışındaki organlarda oluşan kistler, disfonksiyon oluşturmaları nedeniyle semptomları daha hızlı gösterir. Over kistleri diğer organlarla temas halinde olmadıkları ve tipik olarak rutin kontroller sırasında tespit edildikleri için sıklıkla şikayete neden olmazlar. Çeşitli boyutlarda kistlerle karşılaşılsa da dev over kistleri son derece nadirdir. Bu olgu ile kliniğimize kasık ağrısı, karın şişliği ve kabızlık şikayetleri ile başvuran 36 yaşında kadın hasta sunulmaktadır. Ultrasonografik muayenede sol adneksiyel alandan kaynaklandığı düşünülen dev bir kistik kitle izlendi. Sol over kitlesi için cerrahi operasyon yapılmasına karar verildi. Mezoileumdan kaynaklanan 15 × 20 cm boyutlarında kistik kitle mini-phannensteil insizyon ile peroperatif aspirasyon sonrası, duvarı ile birlikte eksize edildi. Bu olgudan yola çıkarak dev over kistlerinin mezenterik kistlerle karıştırılabileceğini ve dev benign kistlerin mini-phannensteil insizyon ile eksize edilebileceğini göstermeyi amaçladık.

Keywords

akut batın, adneksiyal kitle, dev over kisti, mezenter kisti, mini-phannensteil insizyon, pelvik kitle

Mini-Phannensteil Incision Approach to Giant Ovarian Cyst Mimicking Mesenteric Cyst

Abstract

Cysts can occur in all body tissues, but cysts in organs other than the ovaries present symptoms more rapidly due to the resulting dysfunction. Ovarian cysts often do not cause complaints because they are not in contact with other organs and are typically detected during routine checks. Although cysts of various sizes are encountered, giant ovarian cysts are extremely rare. This report presents the case of a 36-year-old female patient admitted to our clinic with complaints of inguinal pain, abdominal swelling, and constipation. In the ultrasonographic examination, a giant cystic mass thought to originate from the left adnexal area, was observed. A decision to perform surgical operation for the left ovarian mass was made. The cystic mass, 15 × 20 cm in size and originating from the mesoileum, was excised with its wall after peroperative aspiration with a mini-phannensteil incision. Considering this case, we aimed to demonstrate that giant ovarian cysts can be confused with mesenteric cysts and that giant benign cysts can be excised with a mini-phannensteil incision.

Keywords

acute abdomen, adnexal mass, giant ovarian cyst, mesentery cyst, mini-phannensteil incision, pelvic mass

References

• Albers CE, Ranjit E, Sapra A, Bhandari P, Wasey W. Clinician Beware, Giant Ovarian Cysts are Elusive and Rare. Cureus. 2020 Jan 23;12(1):e6753.
• Bhasin SK, Kumar V, Kumar R. Giant ovarian cyst: a case report. JK science 2014; 16: 131-133.
• Moyon MA, León DA, Aguayo WG, Mecias AR, Moyon FX, Tufiño J, Yu A, Molina G. Giant ovarian mucinous cystadenoma, a challenging situation in resource-limited countries. J Surg Case Rep. 2019 Dec 9;2019(12):rjz366.
• Akhras LN, Akhras LN, Faroog S, AlSebay L. A 27-kg Giant Ovarian Mucinous Cystadenoma in a 72-Year-Old Postmenopausal Patient: A Case Report. Am J Case Rep. 2019 Nov 1;20:1601-1606.
• Alver D, Gül C, Celayir AC, Şahin D. A case of ovarian torsion with a serous cyst and coexisting serous cystadenoma in the contralateral ovary. Journal of Pediatric Surgical Specialties. 2009;3:50–52.
• Wu F, Hu M, Cao M, Ou M, Li Q, Liu Z. Giant mesenteric mixed hemangioma misdiagnosed as ovarian cyst: a case report and a literature review. Ann Vasc Surg 2020; 67: 567.e1-567.e4.
• Leite C, Barbosa B, Santos N, Oliveira A, Casimiro C. Giant abdominal cyst in a young female patient: A case report. Int J Surg Case Rep. 2020;72:549-555.
• Ricketts RR. Mesenteric and omental cysts. In: Grosfeld JL, O'Neill JAJ, Coran AG, Fonkalsrud EW, editors. Pediatric surgery. Philadelphia (Pa): Mosby Elsevier; 2006. pp. 1399–406.
• Paramythiotis D, Bangeas P, Karakatsanis A, Iliadis A, Karayannopoulou G, Michalopoulos A. Ideal treatment strategy for chylous mesenteric cyst: a case report. J Med Case Rep. 2018 Oct 17;12(1):317.
• Sinha A, Ewies AA. 2016. Ovarian mature cystic teratoma: challenges of surgical management. Obstetrics and Gynecology International 2016: 1–7.
• Royal College of Obstetricians and Gynaecologists (RCOG). 2011. Management of adnexal masses in premenopausal women. Green Top Guidelines 62. London: Royal College of Obstetricians and Gynaecologists (RCOG).
• Chang CK, Teng SW, Leu FJ. 2005. Laparoscopy versus laparotomy for cystic ovarian teratomas. International Journal of Gynecology and Obstetrics 88:69–70.
• Atilgan R, Pala Ş, Bulu G. Purse-string suture technique using a mini-Pfannenstiel incision to treat large dermoid cysts. J Obstet Gynaecol. 2020 Nov;40(8):1160-1163.
• Abdelazim I, AbuFaza M. Pfannenstiel incision for surgical excision of a huge pelvi-abdominal cystadenoma: a case report. Prz Menopauzalny. 2021 Jun;20(2):99-102.
• Watson L, Gavens E, Pachl MJ, Singh M, Soccorso G, McCarthy LSL, Arul GS. Controlled aspiration of large paediatric ovarian cystic tumours. J Pediatr Surg. 2021 Jul 16:S0022-3468(21)00484-X.