ovaries

1. OVARIAN CYST AND
OVARIAN TORSION
A K O M E A H W E L B E C K

2. OVARIAN CYST

3. PRESENTATION OUTLINE
• INTRODUCTION
• EPIDEMIOLOGY
• ETIOLOGY/RISK FACTORS
• TYPES OF OVARIAN CYST
• SIGNS AND SYMPTOMS
• INVESTIGATION AND DIAGNOSIS
• DIFFERENTIAL DIAGNOSIS
• MANAGEMENT
• COMPLICATIONS
• REFERENCES

4. INTRODUCTION
The ovaries are two small glands located on either side of a woman’s uterus
An ovarian cyst is a fluid filled sac or semi solid within the ovary .

5. EPIDEMIOLOGY
• Ovarian cyst are found on transvaginal sonograms in nearly all Premenopausal and
in up to 18% of all post menopausal women.
• Most of these cyst are functional in nature and benign.
• Functional ovarian cysts can occur at any age (including in utero) but are much
more common in women of reproductive age.
• They are rare after menopause .

6. RISK FACTORS
• Infertility treatment
• Pregnancy
• Hypothyroidism
• Maternal Gonadotropins
• Cigarette Smoking
• Tubal ligation

7. TYPES OF OVARIAN CYST
There are two main types of ovarian cyst
• Functional Ovarian Cyst : These are cysts that develop as part of the menstrual
cycle and usually harmless and short-lived, these are the most common type of
ovarian cyst. Eg. Follicular cyst, corpus luteum cyst ,theca luteum cysts.
• Pathological Ovarian Cyst : These are cyst that occur due to abnormal cell
growth of the ovary; these are much less common .Eg.. Dermiod cyst
,Cystadenomas and endometrioma.

8. SIGNS & SYMPTOMS
1. Most clients with ovarian cysts are
asymptomatic.
2. Some clients may present with
 Dyspareunia
 Frequent with micturition
 Early onset of menarche
 Menstrual irregularities
 Dysmenorrhoea
 Abdominal/Pelvic pain
 Abdominal fullness and bloating
 Nausea and Vomiting

9. INVESTIGATION
• Urine pregnancy test
• Full blood count
• Urinalysis
• Endocervical swabs
• CA-125 blood test
• Ultrasound scan
• CT Scan & MRI

10. MANAGEMENT
• Several factors are taken into account when deciding on the type of treatment for
ovarian cyst;
• The patient’s age
• Whether the patient is pre or post menopausal
• The appearance of the cyst
• The size of the cyst
• Whether or not there are any symptoms

11. CTN
• Medical management
1. Watchful waiting
2. Hormonal birth control pills
3. Analgesics
4. Surgery

12. DIFFERENTIAL DIAGNOSIS
• Acute appendicitis
• Ectopic pregnancy
• Threatened abortion
• Pelvic inflammatory disease
• Intestinal Obstruction

13. COMPLICATIONS
• Ovarian torsion
• Ruptured ovarian cyst

14. OVARIAN TORSION

15. INTRODUCTION
• Ovarian torsion refers to the rotation of the ovary to such a degree to
occlude the ovarian artery or vein .
• It is infrequent but significant cause of acute lower abdominal pain in
women.
• The ovary and fallopian tube are typically involved.

16. EPIDEMIOLOGY
• Ovarian torsion is the fifth most common gynecologic surgical emergency
.
• It can occur at any age ,most commonly in early reproductive years (20 –
39 yrs )
• Approximately 20% of torsion occur during pregnancy.

17. RISK FACTORS
• Pathologically enlarged ovaries (> 6cm)
• Ovarian tumors
• Pelvic surgery
• Pregnancy

18. CLINICAL PRESENTATION
• Lower abdominal pain
• Nausea and Vomiting
• Fever
• Tender adnexal mass

19. INVESTIGATION
• Complete blood count
• urine pregnancy test
• Ultrasound Scan
• Ultrasound with a colour doppler

20. MANAGEMENT
• Analgesics
• Keep nil per os
• surgery

21. COMPLICATIONS
• Chronic Pelvic pain
• Infections
• Peritonitis
• Infertility

22. REFERENCES
Gynaecology by 10 teachers
 medscape
 ncbi.nlm.nih

23. THANK YOU