Abstract

ILEAL GANGRENE SECONDARY TO SEROUS CYSTADENOMA OF OVARY: A RARE BUT CHALLENGING DIAGNOSIS

Kaushik Richa*, Kumar Ashwani, Bansal Priyanka and Singh Vineeta

ABSTRACT

Introduction: Serous cystadenoma, which is among the most common cystic ovarian neoplasm, is a benign surface epithelium tumor. It can cause pressure symptoms due to its large size, but occurrence of intestinal gangrene due to pressure effect is quiet rare. Case Description: A 26 years old female, who was a known case of benign cystic ovarian mass and posted for an elective surgery, presented to our hospital emergency unit with a history of 2 days of progressively increasing pain around the umbilicus which became generalized since 1 day and was associated with nausea and vomiting. On examination, patient was having tachycardia, tachypnea, her blood pressure was 80 mm Hg systolic by palpation and abdomen was tense, tender with generalized guarding and rigidity. Metabolic acidosis was present in arterial blood gas analysis. X-ray abdomen showed ground glass appearance. USG showed minimal free fluid in peritoneal cavity with 15×14×18 cm3 cystic left ovarian mass. After stabilization of general condition of patient, we performed an exploratory laparotomy, which revealed around 15×12×18 cm3cystic left ovarian mass extending up to epigastrium and an intestinal gangrene involving around 20 cm of mid ileum. A left ovarian cystectomy was undertaken with resection of gangrenous ileum and end ileostomy was done. Postoperative course was uneventful and ileostomy closure was done after 2 and a half months. Histopathological examination of ovarian mass suggested the diagnosis of serous cystadenoma. Discussion: This case illustrates the presence of rare complication associated with benign ovarian mass in which early institution of treatment saved the life of patient.

Keywords: Serous cystadenoma, Gangrene, Cystectomy.