Bilateral Torsioned Dermoids Presented With Acute Abdomen


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İpekci A.

Eurasian Journal of Emergency Medicine, cilt.13, ss.41, 2014 (Diğer Kurumların Hakemli Dergileri)

  • Cilt numarası: 13 Konu: 1
  • Basım Tarihi: 2014
  • Doi Numarası: 10.5152/jaem.2014.183
  • Dergi Adı: Eurasian Journal of Emergency Medicine
  • Sayfa Sayıları: ss.41

Özet

A 21 year old woman admitted to our emergency department with

progressive low abdominal pain started in a few hours. She had no surgical,

clinical or family history before. Physical examination revealed tenderness,

defence, rebound in bilateral lower quadrants and a palpable

mass located in right adnexial region. Her complete blood account and

biochemical profile were in normal limits. Contrast enhanced computer

tomography of abdomen showed bilateral ovarian masses containing

fat attenuation which was characteristic for dermoid cysts (Figure 1a-b)

and free pelvic fluid. Additionally in right dermoid, there was hyperattenuating

debris inside and a twisted pedicle (Figure 1b). This appearance

was suggestive for adenexial torsion. Under general anaesthesia surgery

was performed, bilateral torsioned dermoids and gangrene were found.

Postoperative period was uneventful and patient discharged a few days

later. Intratumoral fat attenuation is typical CT finding of dermoids that

found 93% of cases. In some cases a floating mass of hair that called Rochitansky

nodule, teeth or calcification could be detected inside of the

mass. Large cystic teratomas that over 11 cm could lead to torsion of adnex.

No vascular supply on colour Doppler and detection of the twisted

or distended pedicle on CT imaging is suggestive for torsion (1, 2).