Cases reported "Ovarian Diseases"

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1/5. Ruptured tubo-ovarian abscess as a complication of IVF treatment: clinical, ultrasonographic and histopathologic findings. A case report.

    Tuboovarian abscess is a rare complication of IVF treatment, which can be lethal on rupture. Hereby, we present a case of a ruptured tubo-ovarian abscess, following transvaginal ultrasound-guided oocyte retrieval for IVF and transcervical embryo trasfer in a 38-year-old white female patient with five years of primary infertility who underwent aspiration of bilateral hydrosalpinges at the time of oocyte retrieval. This case suggests that the reactivation of latent pelvic infection due to a previous pelvic inflammatory disease (PID) was the possible route of infection after transvaginal ultrasound-directed follicle aspiration--transcervical embryo transfer. We conclude that physicians should consider the diagnosis of tubo-ovarian abscess in the differential diagnosis of abdominal pain, fever and leukocytosis after ovum retrieval and transcervical embryo transfer for IVF treatment. Preservation of the uterus and unaffected uterine adnexa should be attempted in such cases if future pregnancy is desired.
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2/5. An ovary with a twist: a case of interesting sonographic findings of ovarian torsion.

    An otherwise healthy young woman presented to the Emergency Department with abdominal pain. Multiple diagnoses were considered, as must be in cases of women with lower quadrant abdominal pain. Rapid identification of an abnormally enlarged ovary in close proximity to the opposite ovary on pelvic ultrasonography suggested the diagnosis of ovarian torsion. This was verified on laparoscopy. Of note is the fact that normal Doppler flow to both ovaries was demonstrated on pelvic ultrasound. We present this case, and its associated images, with the intent to highlight a readily identifiable sign of ovarian torsion for emergency physicians and to briefly review ovarian torsion's salient clinico-pathologic features.
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3/5. Sequential torsion of the uterine adnexa.

    Sequential bilateral torsion of the uterine adnexa in a young girl led to right and, subsequently, left salpingo-oophorectomy. Acute lower abdominal pain in a young female patient, especially one who has had previous similar episodes, should alert the physician to the possible presence of adnexal torsion. If possible, surgical management of this condition should be conservative--that is, the blood supply should be restored to the adnexa and a viable tube or ovary should be preserved. Contralateral adnexal suspension should always be done, in an effort to prevent bilateral adnexal torsion and to preserve the reproductive potential in these young patients.
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4/5. Tuboovarian abscess following transvaginal oocyte retrieval for in vitro fertilization: imaging appearance.

    All physicians participating in the workup of an infertile patient should be aware of the nonspecificity of the computed tomographic or sonographic finding of a complex adnexal cystic lesion occurring following transvaginal oocyte retrieval for in vitro fertilization. Persistent fever and leukocytosis in conjunction with such lesions should lead to an early presumptive diagnosis of tuboovarian abscess with prompt administration of antibiotic therapy.
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5/5. Ovarian abscess after ovum retrieval for in-vitro fertilization.

    An ovarian abscess is an uncommon surgical emergency that could be lethal. The causes of an ovarian abscess vary, and treatment thereof may unfortunately lead to an oophorectomy. In order to draw the attention of physicians to this rare entity, we present a case of ovarian abscess resulting from follicle aspiration for in-vitro fertilization. Furthermore, with correct preoperative diagnosis and prompt surgical intervention at an early stage, the affected ovary may be salvageable.
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