An uncommon case of an infected ovarian endometrioma

Abderrahim Siati, Meryem El Jawhari, Mohamed Dehayni
International journal of surgery case reports · 2024 · vol. 123(C) , pp. 110204 · doi:10.1016/j.ijscr.2024.110204 · PMID:39181030 · W4401798087
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This report details a rare case of secondary infection in an ovarian endometrioma, presenting as a tubo-ovarian abscess mimic, successfully managed with laparoscopic surgery.

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Abstract

INTRODUCTION AND IMPORTANCE: Ovarian endometriosis is common, most often associated with other endometriotic lesions of the pelvis. Among the classic complications of endometriosis, secondary infection is described but rare. We report a very interesting case of an endometrioma cyst mimicking a tubo ovarian abscess. We describe our diagnosis and surgical management by laparoscopic approach. CASE PRESENTATION: A case of a 32-year-old patient, with a history of surgery for ovarian and deep peritoneal endometriosis, who consulted urgently for pelvic pain syndrome in a febrile context. Emergency laparoscopic surgery showed secondary infection of the endometriosic cyst with the presence of pus. A right adnexectomy was performed. The postoperative follow-up was simple. DISCUSSION: Secondary infection of endometriomas is a classically described but rare complication. Severe endometriosis would be a risk factor for developing a tubo-ovarian abscess with an incidence of 2.3 % in patients with endometrioma. Laparoscopic endometrioma surgery has demonstrated its superiority beyond question, numerous trials have confirmed these data. The benefit is established in terms of pain, infectious risk, scarring, wall complications, adhesion risk, length of hospitalization, return to normal activity, thromboembolic risk and cost. CONCLUSION: Infection of an endometriosic cyst is an exceptional complication. It is necessary to emphasize the particularities of this surgery, namely careful dissection to avoid secondary lesions, particularly digestive.

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endometriosisendometrioma

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chemicals 2
estrogen progestin

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