RESUMEN
Ovarian torsion is a comparatively rare gynecological emergency. It commonly presents with complaints of acute abdominal pain, nausea, and vomiting. It occurs due to twisting of the ovarian pedicle leading to ischemic changes in the ovary. It can even result in complete loss of blood supply, eventually necrosis of the ovary. It is diagnosed clinically and can be confirmed on ultrasound color doppler. The management of ovarian torsion depends on the age of the patient, size of the mass, ovary condition, and USG findings. Early diagnosis and treatment of torsion are necessary to preserve the viability of the ovary. We are reporting a case of a 30-year-old female with right ovarian cyst torsion of size 6.3×6.8×6 cm. Once torsion is diagnosed surgery is the mainstay of treatment, either detorsion and ovariopexy or oophorectomy if the ovary cannot be salvaged.
RESUMEN
Leiomyoma are benign uterine tumors of unknown etiology. Only 5% of the cases are cervical and are usually single. Extraperitoneal leiomyomas leads to pressure symptoms. They may be submucosal, intramural or sub-serosal type. Anterior cervical fibroids are the most common. Central cervical fibroids are described as 揟he Lantern on the dome of St. Paul抯�. A retrospective clinical study of 6 cervical fibroids operated in the department of Obstetrics and Gynecology, in a tertiary care hospital in Mumbai for a period of 24 months from March 2021 to February 2022. Patients were studied with respect to clinical profiles, pre-operative investigations, intra- operative surgical challenges and post-operative surveillance. In our study we observed that cervical fibroids were most commonly diagnosed in the age group of 40-50 years, and most commonly in women of second parity. The most common presenting symptom was pain in abdomen. All patients underwent hysterectomy (abdominal or vaginal), wherein 16% of them required blood transfusion. The largest cervical fibroid operated was 20 x 12 x 10 cm in size with uterus corresponding to 22 weeks of gestation. Excision of cervical fibroids is a challenging procedure due to its close proximity to ureters. It is only with experience and with fine surgical skills that a good patient outcome can be achieved. Even after advent of various alternative management options, surgery remains the mainstay of treatment and is still a surgeon抯 nightmare.