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International Journal of Recent Trends in Science and Technology, ISSN 2277-2812 E-ISSN: 2249-8109

Volume 10, Issue 2, March 2014 pp 315-317

Case Report

A Rare Case of Massive Ovarian Mucinous Cystadenoma with Vesicovaginal Fistula-

An Interesting Case Report

 

Sanjay Kumar Patil1, Viral Kashyap Sheth2, Yamini S. Patil3

1, 3 Associate Professor, 2Senior Resident

Department of Obstetrics and Gynaecology, Krishna Institute of Medical Sciences , Karad, Maharashtra , INDIA.


Academic Editor : Dr. Aher K.R.


Abstract


Our reported case was a 45 old postmenopausal female presented with marked abdominal distension and discomfort since 6 months with dribbling of urine with history of injury to bladder during lower segment ceaserean section. The data were collected by history-taking, clinical examination, laboratory investigations, transabdominal ultrasonographic examination, and by histo-pathological study of the excised surgical specimen. On abdominal examination, a huge ill-defined pelvi-abdominal mass was noticed, extended up to xiphisternum. Pelvic examination revealed normal sized non-pregnant firm uterus and fullness in the cul-de-sac and both adnexae and dribbling of urine. Transabdominal ultrasonography verified a massive multi-loculated cyst without solid components or surface papillary projections, extended up to the subhepatic area, with minimal free intraperitoneal fluid. Staging laparotomy proceed abdominal panhysterectomy with vesico vaginal fistula repair was done. Intraoperatively left ovary was replaced by a large cystic mass (45 × 25 × 30 cm) weighing 15 kg greyish white in colour freely mobile filled with turbid fluid. vesico vaginal fistula opening seen at end of cervix and vagina. Histopathological report confirmed the diagnosis. Postoperative recovery was uneventful and patient was discharged after 20days.This case report emphasizes the significance of thorough evaluation of all women presented with vague abdominal pains. Although the condition is extremely rare, it is a potentially dangerous in its massive form if not timely diagnosed and managed properly. With the increasing awareness of such conditions, more and more cases could be detected,reported and treated early.