A patient at 5 months pregnancy complains of acute lower abdomen pain. On examination cervical os is closed and there is a tender right adnexal mass. On USG there is a normal intrauterine pregnancy with a 6 cm right ovarian dermoid cyst. Most probable diagnosis is?
Correct Answer: Ovarian torsion
Description: Ovarian masses in pregnancy may be symptomatic or incidentally detected on USG. Here since the ovarian mass is extremely tender, it has probably undergone torsion and a Doppler should be done to diagnose torsion followed by an urgent cystectomy Complications of ovarian masses in pregnancy Rupture Torsion Hemorrhage Obstruction in labour Management <5 cm: follow up 5-10 cm: cystectomy in case of torsion, rupture, suspicion of malignancy, sudden increase in size during follow up >10 cm: elective cystectomy in second trimester NOTE: red degeneration is a complication of fibroid in pregnancy Since cervical os is closed, it is not a case of inevitable aboion
Category:
Gynaecology & Obstetrics
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