ovarian cyst and its complication dr. miada mahmoud rady ems /473 gynecological emergencies 3
TRANSCRIPT
Ovarian Cyst And Its Complication
Dr. Miada Mahmoud Rady
EMS /473
Gynecological Emergencies 3
Ovarian Cyst
Definition : An ovarian cyst is a fluid-filled sac that forms on
or within an ovary.
Types :
1. Functional : normal .
2. Follicular .
3. Corpus luteum .
4. PCOD.
Types of Ovarian Cyst
1. Functional cyst :
The most common type of cyst .
During the menstrual cycle, the ovaries form tiny sacs
(cysts) to hold the oocytes Once the oocyte matures, the sac
breaks to releases the oocyte and then disappears .
May be the cause of abdominal heaviness and pain
female experience during menstruation.
Functional cysts are usually harmless, rarely cause pain,
and often disappear within two or three menstrual cycles
Types of Ovarian Cyst
2. Follicular cyst :
Result from failure of the follicle to rupture and release
the oocyte.
As result oocytes grows and turns into a follicle.
Normally disappears within 1 to 3 months.
Types of Ovarian Cyst
3. Corpus luteum cyst :
It occurs as result of sealing the site of oocyte release
from follicle.
As result the corpus luteum grows and starts to
accumulate fluid forming cyst .
Corpus luteum cyst secretes estrogen and progesterone.
Fertility drugs can increase the chances of corpus luteum
cysts developing.
Corpus luteum cyst
Bilateral Huge Corpus Luteum Cyst As Result of Fertility Drugs
Types of Ovarian Cyst
4. Polycystic ovarian disease ( PCOD):
• Result from repeated and excessive cyst formation with
failure of ova release .
• Exact etiology is unknown.
• It is spectrum of both clinical and morphological
abnormalities in women with an endocrine dysfunction
mainly abnormal androgen production and metabolism.
Polycystic ovarian disease ( PCOD)
Pathophysiology :
1. Increased androgen and decreased estrogen leading to
menstrual irregularities acne and excessive hair growth.
2. Insulin resistance leading to diabetes and obesity.
3. Increased incidence of hypertension and ischemic heart
disease.
Polycystic ovarian disease ( PCOD)
Clinical presentation :
1. Absent or irregular menstruation .
2. Infertility .
3. Hirsuitism .
4. Acne .
5. Obesity .
6. Insulin resistant , metabolic syndrome and D.M.
PCOD
After Drilling
Before Drilling
Clinical presentation of uncomplicated ovarian cyst
1. Dull, achy pain in the lower back and thighs.
2. Abdominal pain or pressure.
3. Nausea and vomiting.
4. Breast tenderness.
5. Abnormal bleeding and painful menstruation.
6. Painful intercourse.
OVARIAN CYST COMPLICATION
1. Rupture .
2. Torsion.
3. Abscess Formation.
Complicated ovarian cyst is a true gynecological
emergency.
Rupture of ovarian cyst
Leads to Internal Hemorrhage And Acute Abdomen.
Signs and symptoms include:
1. Sharp lower abdominal pain.
2. Abdominal distention , tenderness and rigidity.
3. Dizziness , Weakness and Syncopal episode.
Ovarian torsion
Occurs when the cyst reaches a considerable size causing the
ovary to twist which impair its blood supply .
Treatment : surgery .
Clinical presentation :
Abdominal
Pain
Criteria Of The Pain of Ovarian Torsion
1. Onset : sudden .
2. Provocation: walking .
3. Quality : sharp.
4. Radiation and reference : radiate to the back or thigh
5. Severity : sever .
6. Site : unilateral lower abdominal pain .
7. Associated symptoms : nausea and vomiting.
Abscess Formation
Called Tubo-ovarian abscess .
Most common causes :
1. Gonorrheal PID.
2. Appendicitis .
3. Diverticulitis.
Fallopian tubes or ovaries become blocked by an infectious
mass, which grows and forms an abscess.
Tuboovarian abscess
Symptoms
1. Fever .
2. Headache .
3. Anorexia .
4. Malaise .
5. Nausea and vomiting .
6. Abdominal pain .
Signs
1. Abdominal tenderness .
2. Rebound tenderness .
3. Rigidity.
4. Guarding .
5. Abdominal distension.
6. Absent intestinal sounds .
Management of complicated ovarian cyst
1. Ensure patent airway and anticipate vomiting so keep patient in
left lateral position.
2. High flow oxygen .
3. Continuously monitor vital signs and evaluate the presence of
shock.
4. Give analgesic if allowed
5. Transport rapidly and inform hospital about your diagnosis and
patient condition.
Prolapsed uterus
Definition : drop of the uterus from its normal position into
vagina .
Etiology : occurs due to weakness of muscles and ligaments
holding uterus in its position which may be due to :
1. Age .
2. Child birth .
3. Obesity .
4. Low estrogen levels .
Clinical presentation
1. Vaginal , pelvic pain and Low back pain,.
2. Dysuria and Incontinence.
3. Infection and bad smelling discharge.
4. Varying degrees of feeling like something is falling out of or
bulging from their vagina.
Management
Prehospital treatment is limited to:
1. Pain management and Treatment for shock if present
2. Do not replace any tissue and Cover with warm, moist
dressings.
3. Do not let the patient walk.
Definitive treatment includes : devices to hold the organs in
place or surgery.
Home work
Enumerate complication of ovarian cyst and mention the
clinical presentation and management of one.
Any questions??