EC Gynaecology

Ovarian cysts are common and affect females of all ages; most cysts are managed conservatively, but could require a surgical intervention when complicated. Torsion of an ovarian cyst is the 5^th most common gynecological emergency presenting at the adult emergency. Although ovarian cysts are common, diagnosing a giant ovarian cyst is rare, and even rarer in the peri-partum period, because of the advent and common use of ultrasonography. We presented the case of a 34-year-old P2 (2A) who presented 46 days postpartum with symptomatology that began while she was in her last trimester. She was diagnosed with a giant haemorrhagic cyst that was complicated by a 540-degree torsion, for which she had an emergency laparotomy. The surgery was successful, and the sample was sent for histology. The result of the histology confirmed the diagnosis; she was discharged home 3 days after the surgery. This case showed the possibility of a giant cyst coexisting with pregnancy; and clinicians, need a high index of suspicion to make the diagnosis.

 Keywords: Giant Ovarian Cyst; Haemorrhagic; Torsion; Emergency; Postpartum

1. Zahidy A and Abdulkareem Z. “Causes and management of ovarian cysts”. Egyptian Journal of Hospital Medicine 10 (2018): 1818-1822.
2. Kiemtoré S., et al. “Diagnosis and management of a giant ovarian cyst in the gravid-puerperium period: a case report”. BMC Pregnancy Childbirth1 (2019): 523.
3. Mobeen S and Apostol R. “Ovarian cyst”. StatPearls Publishing, Treasure Island (FL) (2023).
4. Albers CE., et al. “Clinician beware, giant ovarian cysts are elusive and rare”. Cureus 1 (2020): e6753.
5. Bhasin SK., et al. “Giant ovarian cyst: a case report”. JK Science3 (2014): 131-133.
6. Abduljabbar HS., et al. “Review of 244 cases of ovarian cysts”. Saudi Medical Journal7 (2015): 834-838.
7. Peiretti M., et al. “Effective surgical management of a large serous ovarian cyst in a morbidly obese middle-aged woman: a case study and literature review”. American Journal of Case Reports 24 (2023): e939697-1.
8. Ekweani JC., et al. “An 8-year review of ovarian cyst accidents at a tertiary health center in Northwestern Nigeria”. Tropical Journal of Obstetrics and Gynaecology 3 (2016): 307.
9. Sorinola O and Cox C. “Accidents to ovarian cysts”. The Obstetrician and Gynaecologist1 (2002): 10-15.
10. Jyoti M. “Accidents to ovarian cysts”. Journal of Universal College of Medical Sciences2 (2013): 46-53.
11. Sen S., et al. “Atypical presentation of a giant hemorrhagic ovarian cyst”. Journal of Obstetrics and Gynecology of India 2 (2022): 435-438.
12. Gul E., et al. “Ovarian torsion as an emergency clinical entity”. Medicine Science1 (2020): 100-102.
13. Mantecon O., et al. “A case of hemorrhagic ovarian cyst rupture necessitating surgical intervention”. Cureus 9 (2022): e29350.
14. Abbas AM., et al. “Hemorrhagic ovarian cysts: Clinical and sonographic correlation with the management options”. Middle East Fertility Society Journal 1 (2016): 41-45.
15. Numa SE. “The influence of environmental factors on the incidence of ovarian cysts among Nigerian women-a systematic review” (2023).