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Torsion and ruptured ovarian cystadenocarcinoma with internal bleeding complicated with retroperitoneal hematoma after tumor transection: A case report.

Medicine (Baltimore)

January 2025

Department of Obstetrics and Gynecology, Minimally Invasive Gynecology Surgery Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.

Rationale: Ovarian tumor torsion is a critical gynecological emergency, predominantly affecting women of reproductive age, with benign teratomas being the most common culprits. In contrast, malignant ovarian tumors, such as mucinous cystadenocarcinoma, infrequently present with torsion due to their invasive and angiogenic characteristics. The occurrence of torsion in malignant tumors complicates diagnosis and management, particularly when associated with complications like congestion, infarction, and internal bleeding.

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Heterotopic pregnancy is defined as the simultaneous presence of an intrauterine and an extrauterine pregnancy and is considered a rare condition. As a part of this entity, heterotopic triplet pregnancy, defined as the presence of three embryos, with at least one being ectopic, is exceedingly rare. In recent years, the broad use of assisted reproductive techniques to help infertile couples has contributed to the constant rise of non-spontaneous heterotopic triplets.

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Ruptured Endometrioma Associated With Acute Appendicitis: A Case Report.

Cureus

December 2024

Department of Radiology, Souss Massa University Hospital Center, Faculty of Medicine and Pharmacy, Ibn Zohr University, Agadir, MAR.

Endometrioma is a localized form of endometriosis, usually found within the ovaries bilaterally, containing degenerated blood products resulting from bleeding of ectopic endometriotic tissue at different ages. Rupture of the endometrioma is a rare complication that may result in hemoperitoneum and peritonitis and thus presents similarly to other more common abdominal emergencies, and the concomitant presence of a ruptured endometrioma and another abdominal emergency, although exceptional, remains possible. Ultrasonography and sectional imaging can be used to assess a diagnosis that is often confirmed postoperatively.

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This case report describes a rare instance of intraperitoneal rupture in a redegenerated uterine fibroid during pregnancy. A 38-year-old woman at 38 weeks gestation, with a history of a single pregnancy, presented with mild pelvic pain persisting through late pregnancy. An emergency caesarean section was performed due to acute fetal distress during labor.

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Uterine rupture is a rare but serious complication that predominantly occurs in the third trimester of pregnancy. It is exceptionally uncommon in the second trimester, particularly in the presence of uterine anomalies such as a bicornuate uterus or uterus didelphys. This case report presents a significant instance of second-trimester uterine rupture associated with a bicornuate uterus, resulting in a life-threatening intra-abdominal hemorrhage of approximately 4000 mL.

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