Ovarian Cyst Accidents Diagnosed at Laparotomy, experience from a Third-level Health Facility in Port Harcourt, Nigeria
Keywords:
Port Harcourt, Accident, Cyst, OvaryAbstract
Background: Ovarian cyst accidents affect different age groups and usually present as acute abdomen, often requiring surgical intervention. Prompt diagnosis is necessary to maintain reproductive function and avoid mortality.
Objectives: To determine the sociodemographic characteristics, clinical management, and histological patterns of surgically identied ovarian cyst accidents at the University of Port Harcourt Teaching Hospital.
Methods: A retrospective review of all cases of accidented ovarian cyst at laparotomy was undertaken over an Eight-year period. Information on the socio-demographics, symptomatology, operative ndings and histology was extracted and collated in a pre-structured spreadsheet. Analysis of data collated was done using IBM SPSS version 22. Results of the analysis were presented using descriptive statistics, figures and tables. Chi-square test was used to determine the association between categorical variables
with P-value < 0.05 as signicant
Results: Ovarian cyst accidents constituted 123(6.1%) of 2,019 major Gynaecological surgeries (2,019). The age range was 10 –70 years with a mean age of 24.6 ±0.85 years. The majority of patients were in the age group of 21 – 30 years 64(52.0%), and Seventy patients (56.9%) were nulliparous. Abdominal pain was the commonest presentation 105(85.4%), while torsion 105(84.6%) was the most frequent accident. Most cases of accidents were in non-gravid patients 98(95.1%). Fifty-six (45.5%) of ovarian cyst accidents involved the right ovary. There was no significant relationship between age, laterality, parity, gravidity and ovarian accidents. All accidented ovarian cysts were histologically benign.
Conclusion: Accidented ovarian cysts were benign on histology and commonly seen in nulliparous women in their reproductive age group. Torsion is predominant; thus prompt intervention is essential to conserve fertility and hormonal milieu.
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References
1. Mishra J. Accidents of the ovarian cyst. J Univ C Med Sci. 2013;1(2):46-53.
2. Sasaki KJ, Miller CE. Adnexal torsion: review of the literature. Journal of minimally invasive gynecology. 2014; 21(2) 196-202.
3. Shannon M Grabosch. Ovarian cysts: Practice Essentials, Background, Pathophysiology. (accessed 12th January 2020)
4. Body S, Phillips C. Gynaecological causes of abdominal pain. Surgery Oxford International Edition. 2018; 36(5): 252-256.
5. Bottomley C, Bourne T. Diagnosis and Management of Ovarian Cyst Accidents. Best Pract Res Clin Obstet Gynaecol.2009;23(5):711-24
6. Dill-Macky MJ, Atri M. Ovarian Sonography. In: Callen PW, ed Ultrasonography in Obstetrics and Gynaecology: WD Saunders; 2000:857-896
7. Lee EJ1, Kwon HC, Joo HJ, Suh JH, Fleischer AC. Diagnosis of ovarian torsion with color Doppler sonography: depiction of twisted vascular pedicle. J Ultrasound Med.1998; 17(2):83-9.
8. Jain KA. Sonographic spectrum of haemorrhagic Ovarian Cyst. J Ultrasound Med.2002; 21(8):879–886.
9. Sorinla O, Cox C. Accidents of the ovarian Cyst. Obstet Gynaecol.2002;4(1):10-15
10.Ekweani JC, Oguntayo A, Kolawole A, Zayyan M. An 8-year review of ovarian cyst accidents at a tertiary health center in North-Western
Nigeria. Tropical J of Obstet and Gynecol. 2016; 33 (3): 307-309.
11. Chen L, Ding J, Hua K. Comparative analysis of laparoscopy versus laparotomy in the management of ovarian cyst during pregnancy. J
Obstet Gynaecol Res.2014;40(3): 763–769. doi:10.1111/jog.12228
12. Forae GD, Aligbe JU. Ovarian tumors among Nigerian females: A private practice experience in Benin-City, Nigeria. Adv Biomed Res.2016; 5:61. doi:10.4103/2277-9175.179183
13.Lomano JM, Treiford JD, Ullery JC. Torsion of the uterine adnexa, causing an acute abdomen. Obstet Gynecol. 1970; 35(2): 221-225.
14.Zahra F. Pattern of benign ovarian cysts in Qatari women. Qatar Med J. 2016; 2016(2):17-17.
15.Ajani MA, Aramide KO, Salami A, Okolo CA. Histopathological pattern of primary ovarian neoplasms in south-western Nigeria. Jos J Med.
2016; 10(1): 1-8.
16.Ikechebelu JI. Prevalence of gynaecological disease in Nnewi, Nigeria. Nigerian Journal of clinical practice. 2005; 8(2): 136-137.
17.Bayer AI, Wiskind AK. Adnexal torsion: can the adnexa be saved? Am J Obstet Gynecol 1994;171(6): 1506- 1511.
18.Mandiwa C, Shen L, Tian Y, Song L, Xu G, Yang S et al. Parity and risk of ovarian cysts: Cross-sectional evidence from the Dongfeng-
Tongji cohort study. J. Huazhong Univ. Sci. Technol. 2016;36, 767–771.
19. Leslie B, Malcolm CP, Ronald KR, Howard LJ, James BB, Brian EH. Estrogen and Sex Hormone- Binding Globulin Levels in Nulliparous and Parous Women. J Natl Cancer Ins.1985;74(4) 741–745.
20. Nalini YL, Sharma D, Chandra AS, Deepshika BL. A clinical study of large ovarian cyst with study. Int J Reprod Contracept Obstet Gynecol.2017; 7(1): 239-240.
21. Abduljabbar HS, Bukhari YA, Al Hachim EG, Ashour GS, Amer AA, Shaikhoon MM et al. Review of 244 cases of ovarian cysts. Saudi Med J. 2015; 36(3): 834-838.
22.Sznurkowski JJ, Emerich J. Endometriomas are more frequent on the left side. Acta Obstet Gynecol Scand. 2008; 87(1): 104-106.
23.Baker TE, Copas PR. Adnexal torsion. A clinical dilemma. J Reproductive Med. 1995; 40(6): 447-449.
24.Eltabbakh GH. Laparoscopic surgery for large ovarian cysts: review. Trends Gynecol Oncol. 2016; 3(5): 315-318.
25.Nowak M, Szpakowski M, Malinowski A, Maclolek – Blewniewska G, Wilczynski JR, Wladzinski J et al. Laparoscopy and laparotomy in the operative treatment of ovarian cysts. Ginekologia Polska. 2000; 71(9): 1173-1178.
26.Amin SM, Olah F, Babani RM, Liman M I, Abubakar S J.Histopathological analysis and clinical correlations of ovarian lesions in a tertiary hospital in Nigeria: A 10-year review. Annals Trop Pathol. 2017; 8:25-28.
27.Forae GD, Aligbe JU. A histopathological overview of ovarian lesions in Benin City, Nigeria: How common are the functional cysts? Int J Med Public Health. 2014; 4(3):265-268.
28.Patrick UE, Lucky KE. Benign ovarian tumors in a tertiary care hospital in Niger Delta, Nigeria: a 10 year histopathological study. Int J Curr
Res Rev 2015; 7(8): 71-74.
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