Ovarian abscess as a complication of assisted reproduction techniques: a case report

AMP makes true great strides these last decades. Logically some complications were noticed even due to ovarian puncture such as hemorrhage, perforation or infection. The aim of this report is to try, through a review of literature, to draw the attention of physicians to a rare entity, ovarian abscess after follicle aspiration for in-vitro fertilization, and to means of prevention. We report a 38-year-old woman who was compolaining from lower abdominal pain located in the left iliac fossa one month after failed IVF trial. The pain was associated with fever and vomiting. The patient's past medical history involves 2 myomectomys [2003-2007]. On admission, her temperature was 38.9°C and her blood pressure was 90/60 mm Hg. Physical examination found nondistended abdomen. Tenderness to deep palpation in the left lower quadrant, without peritoneal signs, was detected. No masses were palpated. Mild tenderness in the left cul-de-sac was found. A full blood count showed a white cell count of 17,500 cells/mm3 with 84.5% polymorph nuclear cells, CRP 173 mg/dl. Pelvic ultrasound shows a left latero uterine mass; right ovary and the uterus are unremarkable; there was no free abdominal fluid. The laparotomy was performed 24 hours later and a left ovarian abscess was found. The treatment was conservative. Antibiotics were associated during 15 days. The clinical evolution was satisfying. The ovarian puncture might be technically difficult, incomplete, and even impossible which exposes to a greater infection risk. An ultrasound evaluation of ovarian accessibility is necessary before starting an IVF attempt, especially in case of overweight or history of abdominal or pelvic surgery, endometriosis tubal abnormalities or myomas. The treatment is based on surgery and antibiotics

[Laparoscopic management of ovarian cysts in postmenopausal women]

To report our experience with laparoscopic treatment of ovarian cysts in postmenopausal women. During the period January 2000 to December 2006, 18 postmenopausal women were admitted for laparoscopy. The indications for the operation were an ovarian cyst that did not meet the criteria of a simple cyst, or was larger than 4 cm. The median age of the patients was 55 [range 43-82]. The mean time since menopause was 6 years [range: 1-30 years]. All laparoscopies were successfully accomplished. No case of malignancy was found. Histological examination revealed 15 serous cysts, one mucinous cyst, one endometroid cyst and one functional cyst. Neither intraoperative nor post-operative complications occurred. There was no surgery-related mortality. Mobilization of all women was carried out within 12 h of the operation. The mean hospitalization stay was 2 days. Laparoscopic management of carefully selected ovarian cysts is an appropriate alternative for exploratory laparotomy even in elderly patients with or without underlying diseases

Spontaneous ovarian hyper stimulation syndrome and deep vein thrombosis in a non pregnant woman: case report

To assess aetiological factors and complications in a patient with severe ovarian hyperstimulation syndrome [OHSS] and internal jugular vein thrombosis

Case: A 27-year-old non pregnant woman with bilateral ovarian masses who had underwent laparotomy for suspicion of malignant tumor. The pathological examination disclosed malignancy and the diagnosis of OHSS were confirmed. The postoperative evolution was complicated by internal jugular, subclavian vein thrombosis and pulmonary embolism. All biological parameters were negative. The evolution was good

Conclusion: The incidence of thromboembolism in women with OHSS is low and the typical finding is deep venous thrombosis in the neck area. Preventive measure of OHSS is very important, and the patients must be treated timely and correctly once OHSS occurs