Med Bull Sisli Etfal Hosp. 2023; 57(2): 283-286 | DOI: 10.14744/SEMB.2022.08941

A Displaced Mass in the Abdomen, Torsioned Ovary Cyst

Alper Divarci¹, Evrim Kiray Bas¹, Ali Bulbul¹, Halil Ibrahim Ada², Mesut Demir^3
1Department of Neonatology, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye
²Department of Radiology, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye
³Department of Pediatric Surgery, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye

Ovarian cysts are one of the most common pathologies in the infancy period. Approximately 15% of intraabdominal masses seen in this period are genital origined and one-third of these masses are ovarian cysts. The incidence of ovarian cysts has been reported as 1 in 2500 live births. The most common complications in ovarian cysts are torsion and bleeding. Fetal ovarian cysts usually regress spontaneously in complicated cysts; laparoscopic or open surgery can be applied. A female infant with a diagnosis of intraabdominal cystic mass, suspicion of duodenal atresia, and mesenteric cyst made based on a prenatal ultrasonographic imaging was hospitalized in the neonatal intensive care unit for examination and treatment. The abdominal ultrasonography revealed a cystic lesion in the lower left quadrant. The patient was evaluated with abdominal CT for detailed evaluation 1 day later and revealed a cystic lesion in the right upper quadrant. The displacement of the cystic mass conducted the differential diagnosis in favor of mesenteric cyst and ovarian torsion. Laparoscopic surgery was performed for examination and treatment. It was observed that the left ovary was torsioned and displaced. Ovarian cysts are the most frequently observed masses among prenatal cystic masses in female fetuses. It should be kept in mind that cystic masses detected in the prenatal period may often be ovarian cysts and that these cysts can be displaced in the abdomen while torsion, and a treatment plan should be determined according to the clinical findings of the patient.

Keywords: Fetal ovarian cyst, neonatology, newborn, torsioned ovary cyst

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Karýnda yer deðiþtiren kitle, torsiyone over kisti

Alper Divarci¹, Evrim Kiray Bas¹, Ali Bulbul¹, Halil Ibrahim Ada², Mesut Demir^3
1Saðlýk Bilimleri Üniversitesi, Þiþli Hamidiye Etfal Eðitim ve Araþtýrma Hastanesi, Neonatoloji Kliniði, Ýstanbul
²Saðlýk Bilimleri Üniversitesi Þiþli Hamidiye Etfal Eðitim ve Araþtýrma Hastanesi Radyoloji Kliniði, Ýstanbul
³Saðlýk Bilimleri Üniversitesi Þiþli Hamidiye Etfal Eðitim ve Araþtýrma Hastanesi Çocuk Cerrahisi Kliniði, Ýstanbul

Over kistleri, yenidoðan döneminde sýk görülen batýn içi kitle nedenleri arasýnda yer almaktadýr. Over kistlerinin görülme sýklýðý 2500 canlý doðumda bir olarak bildirilirken en sýk görülen komplikasyonlarý torsiyon ve kanamadýr. Tedavide fetal over kistleri genellikle kendiliðinden gerilerken komplike olgularda acil cerrahi giriþim hayat kurtarýcý olmaktadýr. Yaþamýn ikinci gününde acil laporoskopik tedavi gereksinimi olan ve over torsiyonu tanýsý alan olgumuz, yer deðiþtiren torsiyonun nadir görülmesi nedeniyle sunuldu. Prenatal takiplerinde karýn içi kistik kitle, duodenal atrezi ve mezenter kisti þüphesi olan olgumuz, taný ve tedavinin planlanmasý için kliniðimize yatýrýldý. Öz geçmiþinde 38 gebelik haftasýnda, 2700 g aðýrlýklý kýz bebek, normal vajinal yolla doðmuþtu. Yapýlan incelemelerinde sol alt kadranda kistik lezyon (5,3x4cm) saptandý. Bir gün sonra karýn BT ile detaylý deðerlendirmeye alýnan hastada sað üst kadranda kistik lezyon saptandý. Kistik kitlenin yer deðiþtirmesi ayýrýcý tanýda mezenter kisti ve over torsiyonu olarak deðerlendirildi. Laparoskopik laparotomide sol over torsiyonu olduðu belirlendi. Postoperatif üçüncü gününde hasta ek sorun olmadan taburcu edilidi. Yenidoðan döneminde batýn içerisinde saptanan kistik lezyonlarda over kisti düþünülmelidir. Over kistinin torsiyonu durumunda karýn içerisinde yer deðiþtirebileceði unutulmamalýdýr. (SETB-2022-10-216)

Anahtar Kelimeler: Fetal over kisti, neonatoloji, yenidoðan, torsiyone over kisti

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