GEBELİKTE TANI KONULAN RETROPERİTONEAL KİTLEYE YAKLAŞIM: OLGU SUNUMU

Abstract

13 haftalık gebeliği bulunan olgunun rutin kontrollerinde tesbit edilen 11 cm ‘lik adneksial kitlesine yaklaşım değerlendirilmiştir. Çekilen abdominal MR’da; pelvik bölgede uterusu ve sigmoid kolonu belirgin derecede sağa deplase eden 112x87x104 mm boyutlarında keskin sınırlı, belirgin derecede vaskülaritesi mevcut olan solid özellikte lezyon ve sol böbrekte pelvikalisiyel yapılar ve sol üreter belirgin derecede genişlemiş görünümde izlendi. Hasta 13 haftalık gebeliği mevcut iken üroloji kliniği ile birlikte operasyona alınıp, retroperitoneal alandan kaynaklanan 12x12 cm lik kitle ekstirpasyonu yapıldı. Perioperatif gelişen mesane injurisi primer onarılarak, sol hipogastrik arter ligasyonu, sol a.uterina ligasyonu yapıldı. Gebelik sırasında adneksiyal kitlelere yaklaşım hastanın semptomlarına, gebelik haftasına ve kitlenin büyüklük ve özelliklerine göre belirlenir. Olgumuzda kitlenin 12 cm den büyük olması, MR’da solid görünümlü olması, ve malign bir kitleyi düsündürmesi, bası semptomlarının olması nedeniyle laparotomi gerçekleştirilmiştir

Keywords

• Gebelik, Retroperitoneal Kitle, Üreteroneosistostomi.

Abstract

The approach towards an 11cm adnexal mass found during routine checks of a patient in her 13th week of gestation has been evaluated. The abdominal MRI scan shows a sharp edged solid lesion with significant vascularity and dimensions of 112x87x104mm. The lesion visibly displaces the uterus and the sigmoid colon to the right in the pelvic region. The MRI scan also shows pelvicalyceal structures in the left kidney and that the left ureter is significantly enlarged. The 13 weeks pregnant patient was operated together with the urology clinic and an excision was performed on a 12x12cm mass in the retroperitoneal space. Primary repair of bladder injury performed perioperatively. Left hypogastric artery ligation, and left a.uterina ligation were also performed. The approach to adnexal masses during pregnancy depends on the patient's symptoms, the pregnancy week, the size and the characteristics of the mass. Since the mass was larger than 12cm, looked solid in the MRI scan, was indicative of a malignant mass, and had certain symptoms, laparotomy was performed on the patient.

Keywords

• Pregnancy, Retroperitoneal Mass, ureteroneocystostomy

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