Successful laparoscopic resolution of subileus following ethanol sclerotherapy of an ovarian cyst: A case report

Akiko Shoda, Masaru Hayashi, E. Motegi, Takayuki Okazaki, M. Kitazawa, Ichio Fukasawa, Noriyuki Inaba
In: JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY · 2011 · vol. 27(2) , pp. 391–395 · doi:10.5180/jsgoe.27.391 · W2321392653
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

A laparoscopic lysis of adhesions successfully treated subileus in a patient experiencing intestinal problems due to prior ethanol leakage during ovarian cyst sclerotherapy.

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This paper is a 2011 case report describing a 26-year-old woman who developed severe constipation and later sudden right lower abdominal pain years after transvaginal ultrasound-guided aspiration and ethanol sclerotherapy for a right ovarian endometrial cyst. Clinicians diagnosed a ruptured right ovarian cyst with subileus and laparoscopically found extensive pelvic adhesions involving the small intestine, sigmoid colon, omentum, and the abdominal wall; past ethanol leakage was presumed as the cause based on adhesion distribution and characteristic fibrous peritoneal changes around the pouch of Douglas, with no alternative explanation noted. After laparoscopic lysis of adhesions, her intestinal problems resolved and abdominal imaging parameters improved. This paper is centrally about endometriosis — it reports ethanol sclerotherapy complications related to an ovarian endometrial (endometriosis) cyst leading to pelvic adhesions and subileus.

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Abstract

Transvaginal ultrasound-guided aspiration and sclerotherapy with ethanol is a conservative means of treating an ovarian endometrial cyst. Its simplicity, minimal invasiveness, and a relatively low recurrence rate make it an attractive option. However, if ethanol should leak into the pelvic cavity, inflammation is incited, and pelvic adhesions may result. Herein, we report a case of successful laparoscopic surgical intervention for a subileus due to past ethanol sclerotherapy. The patient, a 26 year-old single female, underwent ethanol sclerotherapy eight years previously at another hospital for a right ovarian cyst. During the procedure, some leakage of ethanol was evident, and she had since suffered from intestinal problems, such as severe constipation. Sudden onset of severe right lower abdominal pain prompted her visit to our center. Based on our evaluation, a diagnosis of the ruptured right ovarian cyst and subileus was made. Laparoscopic findings documented extensive adhesions of small intestine, sigmoid colon, and omentum with abdominal wall. Rupture of a right ovarian cyst was also confirmed. Past ethanol leakage was the presumed etiology, because (1) the adhesions were mostly limited to pelvic cavity, (2) sclerotic, thickened, fibrous peritoneum and band-like adhesions had formed around the pouch of Douglas, and (3) there was no other likely explanation. Following laparoscopic lysis of adhesions, her intestinal problems resolved and pertinent diagnostic parameters (ie, abdominal x-ray) have subsequently improved. We conclude that if the ethanol sclerotherapy is elected, the possibility of ethanol leakage should be subject to direct scrutiny and precautionary measures should be taken to avoid later complications.
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Case report Successful laparoscopic resolution of subileus following ethanol sclerotherapy of an ovarian cyst: A case report 2011 Volume 27 Issue 2 Pages 391-395 Details Abstract Transvaginal ultrasound-guided aspiration and sclerotherapy with ethanol is a conservative means of treating an ovarian endometrial cyst. Its simplicity, minimal invasiveness, and a relatively low recurrence rate make it an attractive option. However, if ethanol should leak into the pelvic cavity, inflammation is incited, and pelvic adhesions may result. Herein, we report a case of successful laparoscopic surgical intervention for a subileus due to past ethanol sclerotherapy. The patient, a 26 year-old single female, underwent ethanol sclerotherapy eight years previously at another hospital for a right ovarian cyst. During the procedure, some leakage of ethanol was evident, and she had since suffered from intestinal problems, such as severe constipation. Sudden onset of severe right lower abdominal pain prompted her visit to our center. Based on our evaluation, a diagnosis of the ruptured right ovarian cyst and subileus was made. Laparoscopic findings documented extensive adhesions of small intestine, sigmoid colon, and omentum with abdominal wall. Rupture of a right ovarian cyst was also confirmed. Past ethanol leakage was the presumed etiology, because (1) the adhesions were mostly limited to pelvic cavity, (2) sclerotic, thickened, fibrous peritoneum and band-like adhesions had formed around the pouch of Douglas, and (3) there was no other likely explanation. Following laparoscopic lysis of adhesions, her intestinal problems resolved and pertinent diagnostic parameters (ie, abdominal x-ray) have subsequently improved. We conclude that if the ethanol sclerotherapy is elected, the possibility of ethanol leakage should be subject to direct scrutiny and precautionary measures should be taken to avoid later complications. Based on our evaluation, a diagnosis of the ruptured right ovarian cyst and subileus was made. Laparoscopic findings documented extensive adhesions of small intestine, sigmoid colon, and omentum with abdominal wall. Rupture of a right ovarian cyst was also confirmed. Past ethanol leakage was the presumed etiology, because (1) the adhesions were mostly limited to pelvic cavity, (2) sclerotic, thickened, fibrous peritoneum and band-like adhesions had formed around the pouch of Douglas, and (3) there was no other likely explanation. Following laparoscopic lysis of adhesions, her intestinal problems resolved and pertinent diagnostic parameters (ie, abdominal x-ray) have subsequently improved. We conclude that if the ethanol sclerotherapy is elected, the possibility of ethanol leakage should be subject to direct scrutiny and precautionary measures should be taken to avoid later complications. © 2011 Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy Favorites & Alerts Recently viewed articles

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