Torsion legs ovarian cysts: causes, symptoms, treatment
Signs of this disease requires emergency treatment, the torsion legs ovarian cyst leads to the development of more serious complications. The presence women ovarian cysts involves clinical supervision from the attending gynecologist.
What it is
This complication, which develops with the development of inversion or inflection of the movable legs of the cyst. Recurrent symptoms: the occurrence of acute pain in the abdomen, severe vomiting, fever, muscle tension anterior abdominal wall. As a result, the development of this complication there is a need for urgent surgical treatment.
A cyst is formed due to inflammation or hormonal disorders in a woman’s body. Torsion of the cyst primarily occurs at high mobility. This leads to the development of acute disorders of blood flow and stagnation of venous blood in the pathological tumor, with subsequent ischemia and necrosis. If medical care is rendered with delay, the developed peritonitis or severe bleeding in the abdominal cavity.
The exact causes leading to the development of this complication has not been established. But the influence of the following triggering factors:
- the size of the cyst over 7 cm;
- the presence of mobile entities;
- excessive exercise;
- committing sudden movements and changes of body position;
- weak muscles of the anterior abdominal wall;
- the output of education through long legs outside the cavity of the pelvis;
- postpartum and lactation period;
- frequent and prolonged constipation;
The growth of education provokes the lengthening of the legs, which creates conditions for the development of torsion.
Torsion is not possible when large amounts of education because their internal organs hold her still.
This complication is classified according to the following parameters:
Torsion of the ovarian cyst is manifested by different clinical manifestations, the severity of which depends on the type of rotation and compression of nearby vascular bundles and tissues.
Symptoms with full torsion easily diagnosed due to the severe development of complications, a sick woman is in a forced position with given to the stomach feet. There are complaints about the appearance of paroxysmal pain localized in the abdomen, irradiiruet in the back, sacrum and legs; the feeling of nausea resulting in vomiting. Fever, sweating, frequent urination, the appearance of blood discharge from the vagina.
Upon objective examination, the doctor notes the lowering of blood pressure, tachycardia, pallor, decreased tone of skeletal muscles. When performing palpation, the definition of symptom Shchetkina-Blumberg indicates the development of inflammation in the abdomen – palpation and pressure leads to severe pain, and then pain increases sharply. Revealed muscle tension anterior abdominal wall, and signs of bowel obstruction.
In the inspection of the gynecologist determines tumor formation in the area of the ovary on palpation, increased pain.
If after clinical manifestations there is a sharp decline of pain in the abdomen, without pain medicine, the doctors may suspect the development of tissue necrosis of the cyst and death of nerve endings.
Difficulties in the diagnosis of possible partial torsion, especially if the patient is elderly, the pregnant and the girl. The symptoms are not sufficiently pronounced so as there was no full torsion in the cyst, albeit intermittently, but keeps the blood supply. Extremely rarely there is an independent torsion of the ovary without the presence of tumors in it.
For diagnosis of this disease used ultrasound examination of organs of small pelvis and a diagnostic laparoscopy for an accurate diagnosis takes into account the history of the disease and symptoms. The use of other diagnostic methods are not informative in this pathology.
When carrying out diagnostic procedures, the doctor differencial torsion of the appendages cyst from an ectopic pregnancy in women of childbearing age, acute appendicitis, renal colic, salpingoophoritis, and other gynecological diseases with symptoms of acute abdomen.
Symptoms of an acute abdomen in women require emergency hospitalization because of high risk of development of peritonitis, haemorrhage and the formation of adhesions. Treatment when torsion of the cyst appendages aimed at restoring the blood supply to the ovary and give it to the anatomical position.
The type of surgery determined by the physician based on the survey data: the degree of torsion, the size of the formation, time of development of the pathology and symptoms.
With incomplete torsion and the viability of the ovaries is recommended laparoscopic surgery. During surgical intervention to restore the position of the appendage, and remove the benign.
Symptoms of the tissue necrosis, bleeding and peritonitis lead to the need for open surgery, during which removes a cyst with the ovary.
If during the operation appear suspected malignancy of the cyst, the part of the tissue sent for histological examination.
Timely treatment professional medical advice and treatment lead to a favorable prognosis for life of the sick woman.