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Table of Contents
LETTER TO THE EDITOR
Year : 2019  |  Volume : 8  |  Issue : 1  |  Page : 46-47

Single-site laparoscopic management of complicated paraovarian cyst


1 Department of Pediatric Surgery, Hedi Chaker Hospital; University of Medicine, Sfax, Tunisia
2 Department of Pediatric Surgery, Hedi Chaker Hospital, Sfax, Tunisia

Date of Submission17-Sep-2018
Date of Decision26-Oct-2018
Date of Acceptance29-Oct-2018
Date of Web Publication23-Jan-2019

Correspondence Address:
Dr. Sahla Sellami
Department of Pediatric Surgery, Hedi Chaker Hospital, Road El Ain, Sfax
Tunisia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/GMIT.GMIT_89_18

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How to cite this article:
Ammar S, Sellami S, Zouari M, Zitouni H, Mansour MB, Hbaieb M, Bendhaou M, Mhiri R. Single-site laparoscopic management of complicated paraovarian cyst. Gynecol Minim Invasive Ther 2019;8:46-7

How to cite this URL:
Ammar S, Sellami S, Zouari M, Zitouni H, Mansour MB, Hbaieb M, Bendhaou M, Mhiri R. Single-site laparoscopic management of complicated paraovarian cyst. Gynecol Minim Invasive Ther [serial online] 2019 [cited 2019 Feb 19];8:46-7. Available from: http://www.e-gmit.com/text.asp?2019/8/1/46/250650



To the Editor,

Paraovarian cysts are embryonic remnants of the Mullerian and Wolffian ducts, rarely responsible for complications, such as torsion of the cyst and torsion of the ovary or rupture.[1],[2] These complications are often difficult to diagnose.

We report the observation of a 12-year-old female child with no particular medical or surgical history who present for acute abdominal pain evolving for 6 h. The clinical examination showed a 37.5°C temperature with sensitive right iliac fossa. The white blood cells count was 9000 cells/mm3, and the C-reactive protein was 24 mg/L. The abdominal ultrasound with computed tomography suggested the diagnosis of right ovarian torsion. Laparoscopic surgical exploration was decided. The approach of the abdominal cavity was made through a single umbilical incision using a glove port [Figure 1]. The laparoscopic instruments were introduced through this single incision. It was torsion of a right paraovarian cyst [Figure 2]. The right ovary and the appendix were safe. The cyst was completely resected. The extraction of the specimen was performed through the same single incision. Histopathologic examination of the cyst confirmed the diagnosis. The postoperative course was simple with a follow-up period of 10 months.
Figure 1: Single-incision laparoscopy using a glove port

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Figure 2: Laparoscopic view of the paraovarian cyst and the resected specimen

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Paraovarian cyst torsion is a rare complication which occurs in 2%–16% of cases.[1] Ultrasonography or computed tomography may be performed preoperatively, but none of these imaging techniques have specific criteria for diagnosis. Hence, in most cases, misdiagnosis as an ovarian mass remains to be a problem.[3],[4] The diagnosis should be evoked in front of a girl consulting for abdominal pain. Laparoscopy is an important diagnostic and therapeutic tool in case of doubt.[1],[5] Laparoscopy using a single-site incision used in our case was associated with a short hospital stay, less discomfort, and good cosmetic results.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Torky HA, El-Sayed AA. Laparoscopic removal of large gangrenous paraovarian cyst in an adolescent girl. J Biomed Sci Appl 2017;1:10.  Back to cited text no. 1
    
2.
Benkirane S, Alaoui FF, Chaara H, Bougern H, Melhouf MA. Twisted paratubal cyst: Report of a rare case of difficult diagnosis. Pan Afr Med J 2014;19:25.  Back to cited text no. 2
    
3.
Kiseli M, Caglar GS, Cengiz SD, Karadag D, Yılmaz MB. Clinical diagnosis and complications of paratubal cysts: Review of the literature and report of uncommon presentations. Arch Gynecol Obstet 2012;285:1563-9.  Back to cited text no. 3
    
4.
Erikci VS, Payza D, Ergin M, Hosgör M. A paratubal cyst associated with flegmonous appendicitis: A case report and review of literature. J Pregnancy Child Health 2016;3:232.  Back to cited text no. 4
    
5.
Macarthu M, Mahomed AA. Laparoscopy in the diagnosis and management of a complicated paraovarian cyst. Surg Endosc 2003;17:1676-7.  Back to cited text no. 5
    


    Figures

  [Figure 1], [Figure 2]



 

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