Autoamputation of the adnexae due to torsion of previous ovarian cyst : A case report = Autoamputation of the adnexae due to torsion of previous ovarian cyst : A case report

다국어 초록 (Multilingual Abstract)

Background: Torsion of adnexa usually is manifested with severe abdominal pain and is treated as an acute surgical emergency. We report an interesting case of chronic pelvic pain due to torsion of previous ovarian cyst resulting in autoamputation of the adnexae and diagnosed by laparoscopy subsequently. Amputation of an ovary by previous torsion, and sometimes with other adnexal structures as well, are extremely rare. Case: A 61-year-old Korean woman, gravida 4, para 2, complained of dull intermittent lower abdominal pain for 2 years. and visited our gynecology outpatient clinic. Her intermittent lower abdominal pain was subside when she did not move or prostrate on the floor. Pelvic examination, ultrasonography and abdominal computer tomography imaging revealed a various size of multiple myoma, and her serum CA125 and CA 19-9 was normal respectively. Because of the chronicity of her symptoms and image findings she underwent operative laparoscopy.At laparoscopy she was noted to have a pelvic mass in front of uterus with no ligamentous or direct connection with the pelvic organs. There was not the right ovary and tube even though she had no previous operation history. These findings were interpreted as an autoamputation of the adnexae due to torsion of previous ovarian cyst arising from the right ovary. Conclusion: Physicians should bear in mind the possibility of an autoamputated ovarian cyst even if the preoperative radiograph shows no calcification