Ovarian Cyst Accidents Diagnosed at Laparotomy, experience from a Third-level Health Facility in Port Harcourt, Nigeria
Main Article Content
Abstract
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.
Downloads
Article Details
Issue
Section
All articles published in the journal are licensed under a Creative Commons Attribution (CC BY) license(i.e CC Attribution-NonCommercial-ShareAlike 4.0), allowing others to share, distribute, and build upon the work, provided the original author(s) and source are properly cited. Authors retain the copyright of their work.
How to Cite
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 SJ. 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.