Giant ovarian endometrioma presenting as intestinal obstruction

Dhruv Kundra, Megha Panwar
In: International Surgery Journal · 2023 · vol. 10(6) , pp. 1113–1115 · doi:10.18203/2349-2902.isj20231750 · W4381569664
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A 66-year-old postmenopausal woman with a giant ovarian endometrioma causing intestinal obstruction underwent successful surgical removal of the mass and appendix.

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This case report describes a 66-year-old postmenopausal woman who presented with acute intestinal obstruction caused by a giant ovarian endometrioma. Imaging revealed a large right ovarian mass occupying nearly the entire abdominal cavity and adherent to the appendix, which is an exceptionally rare presentation for this condition in postmenopausal patients. The patient underwent exploratory laparotomy involving complete excision of the mass and an appendicectomy to resolve the obstruction. This paper is centrally about endometriosis — specifically a rare complication where a giant endometrioma causes intestinal obstruction in a postmenopausal woman.

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Abstract

Ovarian endometriomas, also commonly referred to as chocolate cysts are seldom found in postmenopausal women. Ovarian endometriomas rarely exceed 10-15 cm in diameter. Its symptoms are non-specific and presentation as acute intestinal obstruction is extremely rare. The present case is of a 66 years old postmenopausal female who presented with symptoms of acute intestinal obstruction. On investigation she was detected with a large right ovarian mass occupying almost entire abdominal cavity and adherent to appendix. She underwent exploratory laparotomy with complete excision of mass and appendicectomy.
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Giant ovarian endometrioma presenting as intestinal obstruction DOI: https://doi.org/10.18203/2349-2902.isj20231750Keywords: Endometrioma, Chocolate cyst, Intestinal obstructionAbstract Ovarian endometriomas, also commonly referred to as chocolate cysts are seldom found in postmenopausal women. Ovarian endometriomas rarely exceed 10-15 cm in diameter. Its symptoms are non-specific and presentation as acute intestinal obstruction is extremely rare. The present case is of a 66 years old postmenopausal female who presented with symptoms of acute intestinal obstruction. On investigation she was detected with a large right ovarian mass occupying almost entire abdominal cavity and adherent to appendix. She underwent exploratory laparotomy with complete excision of mass and appendicectomy. Metrics References Yaşar L, Sönmez AS, Zebitay AG, Neslihan G, Yazıcıoğlu HF, Mehmetoğlu G. Huge ovarian endometrioma–A case report. Gynecol Surg. 2010;7:365-7. Naem K. Free large sized intra-abdominal endometrioma in a postmenopausal woman: a case report. BMC Women's Health. 2020;20:190. Nisolle M, Donnez J. Reprint of Peritoneal endometriosis, ovarian endometriosis, and adenomyotic nodules of the rectovaginal septum are three different entities. Fertil Steril. 2019;112(4s1):e125-36. Oral E, Sozen I, Uludag S, Demirkiran F, Ilvan S, Oncul M et al. The prevalence of endometrioma and associated malignant transformation in women over 40 years of age. J Gynecol Obstet Hum Reprod. 2020;101725. Hulka BS. Links between hormone replacement therapy and neoplasia. Fertil Steril. 1994;62(6-2):168S-75S. Buy JN, Ghossain MA, Mark AS, Deligne L, Hugol D, Truc JB et al. Focal hyperdense areas in endometriomas: a characteristic finding on CT. AJR Am J Roentgenol. 1992;159(4):769-71. Słopień R, Męczekalski B. Aromatase inhibitors in the treatment of endometriosis. Przeglad menopauzalny. Menopause Review. 2016;15(1):43-7.

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endometrioma

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