ovarian torsion and cysts Flashcards
what are risk factors for ovarian torsion?
ovarian mass: present in around 90% of cases of torsion
being of a reproductive age
pregnancy
ovarian hyperstimulation syndrome
what are typical features of ovarian torsion?
Usually the sudden onset of deep-seated colicky abdominal pain.
Associated with vomiting and distress
fever may be seen in a minority (possibly secondary to adnexal necrosis)
Vaginal examination may reveal adnexial tenderness
what will ultrasound findings show of ovarian torsion?
whirlpool sign
what are the 3 types of ovarian cyst you can get?
- functional cyst
- benign germ cell tumour
- benign epithelial tumour
what are the different types of functional cyst?
- follicular cyst- when follicle doesn’t rupture
- corpus luteal cyst - ruptures in menstural cycle if pregnancy has not occurred
what is the main example of a germ cell tumour?
dermoid cyst-> more likely to tort as It is heavier-> contains teeth
what are the different types of benign epithelial tumour?
- serous cyst adenoma- most common
- mutinous- can become massive
what are tests that can be done to identify a germ cell tumour?
- LDH
- Afp
- HCG
how are simple cysts managed in premenopausal women?
depends on size…
- < 5cm… will usually resolve in 3 cycles
- 5-7cm …routine referral to gynea for yearly monitoring with USS
- > 7cm… consider MRI or surgical evaluation as can be difficult to characterise with USS
How are ovarian cysts managed in post menopausal women?
- require a correlation with CA125
- if raised need 2 week wait referral
- if simple cysts <5cm with normal CA125- monitor with USS every 4-6 months… if persistently enlarging then may require surgery
what are complications of ovarian cysts?
- torsion
- haemorrhage
- rupture
what is the triad for Meig’s syndrome?
- ovarian fibroma
- pleural effusion
- ascites
typically present in older women and removal of the tumour resolves the ascites
