Torsion of uterine adnexa is an important cause of acute abdominal pain in females. The main organ which can cause torsion is the ovaries, but torsions of the fallopian tube, subserosal myoma, paratubal cyst, and even the uterine body have been reported. The incidence of isolated fallopian tubal torsion is very rare. Even more rarely, it can coil around nearby organs such as the utero-ovarian ligament, showing similar clinical manifestations with those of adnexal torsion. We experienced an extremely rare case of acute abdomen induced by ovarian congestion triggered by the fallopian tube accompanying a paratubal cyst coiling around the utero-ovarian ligament. The right paratubal cyst was misinterpreted as being part of a cystic component of the left ovary on preoperative sonographic examination, and the coiling of the right fallopian tube accompanying the paratubal cyst was misdiagnosed as torsion of the right ovary. We report this rare case with a brief literature review.
Abdomen, Acute* ; Abdominal Pain ; Estrogens, Conjugated (USP)* ; Fallopian Tubes* ; Female ; Humans ; Incidence ; Ligaments* ; Myoma ; Ovary ; Parovarian Cyst* ; Ultrasonography

On H1 MRS (magnetic resonance spectroscopy), malignant tumors show higher concentration of metabolite than benign lesions. Lactate double peak was detected in malignant tumor and endometriosis, and more prominent high concentration was demonstrated in endometriosis. Tuboovarian abscesses and salpingitis do not show prominent peak. Dermoid cysts show high levels of lipid peak. Paratubal cyst and follicular cyst can be showed the lipid peak, however, the concentration of lipid is lower than that of dermoid cyst. H1 MRS of ovarian cystic lesions can give valuable information about the presence of metabolites of ovarian cystic lesions.
Abscess ; Dermoid Cyst ; Endometriosis ; Female ; Follicular Cyst ; Lactic Acid ; Magnetic Resonance Spectroscopy* ; Ovarian Cysts ; Ovary ; Parovarian Cyst ; Salpingitis

OBJECTIVES: The objective of this study was to assess the clinical characteristics of postmenopausal women who were admitted to the emergency room. METHODS: This study was conducted at a university hospital. The retrospective study of medical records comprised 26 patients who were admitted to the emergency room, between September 2010 and August 2011. RESULTS: The age of the twenty-six patients was 51-90 years. Abdominal pain and vaginal bleeding were the main complaints. The final diagnoses were 6 cases of postmenopausal atrophic vaginitis, 6 cases of ovarian cyst, 5 cases of pelvic inflammation disease, 3 cases of post-conization bleeding, 1 case of menopausal symptoms, 1 case of atrophic endometrium, 1 case of uterine prolapse, 1 case of pyometra, and acute pyeolonephritis with stone. Among the 6 cases of ovarian cyst, 5 cases performed an operation. Pathologic findings revealed 2 cases of simple cyst, 1 case of paratubal cyst, 1 case of teratoma, and 1 case of granulosa cell tumor. CONCLUSION: The incidence of post-menopausal distress in women is increasing, and the numbers of post-menopausal women being admitted to the emergency room are also increasing, so attention needs to be paid to the case of postmenopausal women in the future.
Abdominal Pain ; Atrophic Vaginitis ; Emergencies ; Endometrium ; Female ; Granulosa Cells ; Hemorrhage ; Humans ; Incidence ; Inflammation ; Medical Records ; Menopause ; Ovarian Cysts ; Parovarian Cyst ; Pyometra ; Retrospective Studies ; Teratoma ; Uterine Hemorrhage ; Uterine Prolapse

OBJECTIVE: To evaluated the result of laparoscopic surgery of adnexal tumors and removing excised tissue through Douglas pouch incision. METHODS: 110 patient who had visited Chosun University Hospital department of Obstetrics and Gynecology between January, 2011 to April, 2012 were involved in the study. Patient had laparoscopic surgery on the adnexal tumor and excised tissue was removed through Douglas pouch incision by single surgeon. RESULTS: The mean age of patients were 41.5 years. The size of the tumor varied from 3 cm to 27 cm in size using ultrasonography. The mean operation time was 61.3 minutes and the mean admission period was 4.2 days. 82 patient had salpingo-oophorectomy or oophorectomy, 19 had ovarian cystectomy, 2 had wedge resection and 4 had tumor enucleation. Histologic result reveal endometriosis in 23 patients (20.9%). teratoma in 21 (19%), serous cystadenoma in 14 (12.7%) and mucinous cystadenoma in 10 (9.1%). Other histologic finding includes hemorrhagic cyst, luteal cyst and paratubal cyst. There was no complication including bladder or rectal injury, suture site infection. CONCLUSION: Laparoscopic surgery of adnexal tumor and removal by Douglas pouch incision is a simple, safe and efficient method that could be considered as an alternative minimally invasive technique.
Cystadenoma, Mucinous ; Cystadenoma, Serous ; Cystectomy ; Douglas' Pouch ; Endometriosis ; Female ; Gynecology ; Hospital Departments ; Humans ; Laparoscopy ; Obstetrics ; Ovariectomy ; Parovarian Cyst ; Sutures ; Teratoma ; Urinary Bladder

Although paratubal cysts are well-characterized incidental findings, paratubal serous borderline tumors are very rare, with only one case report in the literature. We describe here a 27-year-old, nulliparous, married woman with a paratubal serous borderline tumor. The patient presented with a huge pelvic mass accompanied by flank pain and underwent paratubal cystectomy and fertility-sparing surgical staging procedures. Thirteen months after surgery, she delivered a healthy baby at term. She is well, without evidence of disease, 20 months after surgery. Because paratubal serous borderline tumors are very rare, their optimal management must be extrapolated from their ovarian counterparts.
Adult ; Cystectomy ; Female ; Flank Pain ; Humans ; Incidental Findings ; Parovarian Cyst

We report two cases of ectopic epididymal ducts and efferent ductules in the testicular appendices (TAs) of adult men with normally descended testes. In both cases, a sessile TA was incidentally found at the upper pole of the right testis during the scrotal hydrocelectomy. Microscopically, a few closely arranged tubules were detected within the TA. In the first case, the tubules were lined with a pseudostratified columnar epithelium with numerous, long microvilli, and were surrounded by a smooth muscle coat. In contrast, in the second case, the tubules had a wavy luminal surface, because ciliated columnar cells alternated with groups of cuboidal cells. In both cases, strong CD10 immunoreactivity was observed in the luminal border of the lining epithelium. Surgical pathologists should be aware of the presence of both ectopic epididymal ducts and efferent ductules that can occur in TAs, in order to avoid misinterpretation as transected, functional reproductive structures.
Adult ; Choristoma ; Epididymis ; Epithelium ; Female ; Humans ; Male ; Microvilli ; Muscle, Smooth ; Parovarian Cyst ; Phenobarbital ; Testis ; Wolffian Ducts

Torsion of the paratubal cyst is a rare but significant cause of acute or recurrent lower abdominal pain in adolescent females that is difficult to recognize preoperatively. Early diagnosis is very important in adolescent because of the risk of decreased fertility if it is not treated at an early stage. We report a case of torsion of the paratubal cyst that has resulted in hemorrhagic infarction of the paratubal cyst and fallopian tube in an adolescent female with brief review of literatures.
Abdominal Pain ; Adolescent ; Early Diagnosis ; Fallopian Tubes ; Female ; Fertility ; Humans ; Infarction ; Parovarian Cyst

PURPOSE: The indications for pediatric laparoscopic surgery are increasing according to the improvement of laparoscopic procedures and instruments and the increased knowledge of its safety and benefits. We summarized the analysis of the outcomes and the feasibility of performing laparoscopic surgery in children. METHODS: We retrospectively analyzed 183 consecutive children (114 males and 69 females) who underwent laparoscopic surgery between June 2001 and July 2007. The following information was obtained: the surgical indications, operative procedures and surgical outcomes. RESULTS: The laparoscopic procedures for each disease were as follows, appendectomy for acute appendicitis (n=143), reduction for barium reduction-failed intussusceptions (n=15), splenectomy for symptomatic hereditary spherocytosis (n=5), salphingoophorectomy for torsion of a parovarian cyst and ovarian tumor (n=2), diverticulectomy or segmental resection for symptomatic Meckel's diverticulum (n=3), cholecystectomy for symptomatic gall stones & adenomyomatosis (n-4), repair for Morgagni hernia (n=1), Nissen's fundoplication for paraesophageal hernia (n=1), Heller myotomy and Dor fundoplication for achalasia (n=1), diagnostic purpose for peritoneal tuberculosis (n=3) and lymphoma (n=1), excision for retroperitoneal neuroblastoma (n=1), peritoneal drainage for postoperative abscess (n=1) and removal of a foreign body in the peritoneal cavity (n=2). The mean age was 9.9 years (range: 4 months to 15 years). There was one conversion for a perforated appendicitis. There were 3 cases of laparoscopic assisted reductions for intussusception. There were three wound infections in the patients with complicated appendicitis. CONCLUSION: Laparoscopic procedures for various pediatric surgical disorders were feasible under the appropriate indications.
Abscess ; Appendectomy ; Appendicitis ; Barium ; Child ; Cholecystectomy ; Drainage ; Esophageal Achalasia ; Female ; Foreign Bodies ; Fundoplication ; Gallstones ; Hernia ; Hernia, Hiatal ; Humans ; Intussusception ; Laparoscopy ; Lymphoma ; Male ; Meckel Diverticulum ; Neuroblastoma ; Parovarian Cyst ; Peritoneal Cavity ; Peritonitis, Tuberculous ; Retrospective Studies ; Spherocytosis, Hereditary ; Splenectomy ; Surgical Procedures, Operative ; Wound Infection

Paratubal cysts come from paraovarium of the broad ligament between the fallopian tube and ovary. Overall, these cysts constitute 10% of all adnexal masses and are commonly incidental findings upon surgical exploration for other reasons. They more commonly occur in women between 30 and 40 years of age. We report two cases of rapidly growing, huge paratubal cysts in young women, which are presented with brief review of literature.
Broad Ligament ; Fallopian Tubes ; Female ; Humans ; Incidental Findings ; Ovary ; Parovarian Cyst

Parovarian cysts, generally known as hydatid cysts of Morgagni, are small round cysts attached by a pedicle to the fimbriated end of the tube. Due to the rarity of this lesion, there are controversies concerning the origin, clinical behavior, treatment and prognosis of these tumors. Parovarian borderline malignancy mostly occur in young women, main complaints are abdominal enlargement and pelvic pain. we experienced one case of parovarian borderline malignancy and report this case with a brief review of literature.
Echinococcosis ; Female ; Humans ; Parovarian Cyst ; Pelvic Pain ; Prognosis