Akademik Veri Yönetim Sistemi
FİGO, İstanbul, Türkiye, 21 - 28 Ekim 2021, ss.1, (Tam Metin Bildiri)
OBJECTIVE:
To report a rare presentation of cyst hydatid and discuss its diagnostic workup and treatment modality.
METHOD:
Two patients, aged 42 and 43, presented with pelvic pain. Bimanual vaginal examinations detected pelvic mass. Transvaginal ultrasonography (TVU) showed a heterogeneous multi-cystic 8-cm structure in Douglas Pouch consisting of well-circumscribed loci of similar shape and size, separated by thick septa in the first patient. Uterus and two ovaries was normal appearance and size. There was 10-cm mass showing similar ultrasonographic appearance in right adnexal area for the second patient. This mass was suspected to be of ovarian origin. Cyst hydatid was included to differential diagnosis with those findings detected at ultrasonographic exam.
Indirect hemagglutinin tests were negative for both patients, MRI results were suspicious for hydatid cysts similarly demonstrated by TVU with normal upper abdomen.First case managed with open abdominal and second case with laparoscopic surgery. Both cases were subjected to prophylactic Albendazole therapy before surgery. In the first patient, the mass was attached to the omental tissue and protruded towards the Douglas pouch. In second, the pelvic mass was observed seated on the fallopian tube attached between the round and infundibulopelvic ligaments. The masses were carefully separated from its surrounding tissues, taken into an endo-bag and removed without bursting.
RESULTS:
For endemic areas, cyst hydatic should come to the minds as a rare reason of adnexal mass and pelvic pain. Even if the indirect hemagglutinin test is negative, if ultrasonographic findings support hydatid cyst, MRI could be helpful.
CONCLUSIONS:
Laparoscopic surgery may be preferred, but cyst should not be ruptured during surgery. If there is a high risk of cyst bursting, laparotomy should be performed.