A rare case of ovarian hyperstimulation with torsion presenting with hypothyroidism

A thirteen years old female child, who was recently diagnosed with hypothyroidism and polycystic ovary and under thyroid supplements, presented with acute abdominal pain of one day duration. Examination showed pallor with rough skin, hypotension (70/40 mmHg) and distended abdomen. Abdomen was tense with tenderness and guarding. Urgent contrast CT abdomen showed bilateral polycystic ovaries with left ovarian torsion and hemo-peritoneum. Blood investigations showed anemia (6.0 g/dL) and TSH >100 microIU/ml. She was stabilized with Intravenous fluids, packed red blood cells and taken up for surgery. Laparoscopy confirmed the diagnosis and detorsion with deroofing of cysts was done. A post-operative diagnosis of Van Wyk Grumbach syndrome - Hypothyroidsm with ovarian hyper stimulation syndrome with hemorrhagic torsion of left ovary was made. She withstood procedure well and was stable. She was discharged to a local hospital after 2 days of surgery. She is on thyroid supplements and doing well

Adnexal torsion-five-year retrospective study

Background: Adnexal torsion is one of the gynecologic emergency conditions requiring prompt diagnosis and surgical treatment to save the ovarian function. This retrospective study is intended to analyze the clinical manifestations and treatment in a tertiary care center.Methods: This is a retrospective study Case records during five-year period of February 2012-2017 in PSG Institute of Medical Sciences and research, Coimbatore, India.Results: Adnexal torsion was seen in all age groups and commonly in reproductive age. It was seen in few pregnant patients also. Lower abdominal pain of acute onset associated with nausea and vomiting was the commonest clinical feature. Ovarian cyst and PCOD were the common risk factors predisposing torsion. Though ultra sound was the common modality used, the diagnosis was done based on strong clinical suspicion with surgical confirmation. The ovaries were preserved in some patients of reproductive age group.Conclusions: Adnexal torsion is one of the gynecologic emergencies. The symptoms and signs are nonspecific and may not have a confirmatory lab or imaging study. Hence a strong clinical suspicion followed by prompt surgical management in both pregnant and non -pregnant patients of any age group saves the ovary and further complications

Intraperitoneal rectal perforation presenting as fetal ascites – a rare occurrence

Spontaneous perforation of the rectum presenting as fetal ascites is an extremely rare occurrence. We report the case of an infant where antenatally detected fetal ascites was attributable to intraperitoneal rectal perforation. Investigations directed to identify common causes of this condition did not reveal any aetiology. Patient underwent surgical colostomy formation on day two of life, which was reversed at six weeks of age. We suggest that meconium ascites and peritonitis should be considered as differential diagnoses in fetuses with ascites and, if the neonate requires a laparotomy, the rectal area should be thoroughly inspected to exclude this entity

Recurrent plunging ranula

We report two cases of plunging ranula, which had recurred after marsupialization. Both were successfully treated by removal of the ipsilateral sublingual gland. A brief review of the literature regarding the treatment options is presented

Adnexal torsion-five-year retrospective study

Background: Adnexal torsion is one of the gynecologic emergency conditions requiring prompt diagnosis and surgical treatment to save the ovarian function. This retrospective study is intended to analyze the clinical manifestations and treatment in a tertiary care center.Methods: This is a retrospective study Case records during five-year period of February 2012-2017 in PSG Institute of Medical Sciences and research, Coimbatore, India.Results: Adnexal torsion was seen in all age groups and commonly in reproductive age. It was seen in few pregnant patients also. Lower abdominal pain of acute onset associated with nausea and vomiting was the commonest clinical feature. Ovarian cyst and PCOD were the common risk factors predisposing torsion. Though ultra sound was the common modality used, the diagnosis was done based on strong clinical suspicion with surgical confirmation. The ovaries were preserved in some patients of reproductive age group.Conclusions: Adnexal torsion is one of the gynecologic emergencies. The symptoms and signs are nonspecific and may not have a confirmatory lab or imaging study. Hence a strong clinical suspicion followed by prompt surgical management in both pregnant and non -pregnant patients of any age group saves the ovary and further complications

A Case Series of Fetal-Neonatal Ovarian Cyst from a Tertiary Care Hospital

The occurrence of ovarian cyst in the neonate is rare and antenatally diagnosed by ultrasonography. This study aims to increase awareness about its occurrence and histological features. We performed a retrospective review on 10 cases of neonatal ovarian cyst (NOC) during 4 years (2016–2020) in a tertiary care center in South India. The neonates were diagnosed with abdominal cysts by the antenatal ultrasonogram in the third trimester. They were operated from day 5 to 35 days of age. There was no side predilection, and most of them were unilateral (9 out of 10 cases). Histopathological examination showed simple cysts (50%), serous cystadenomas (20%), cyst with no viable lining (20%), and follicular cyst (10%) and 90% of the cysts had torsion-induced changes. The pathologist and the clinician should be aware of the occurrence of serous histology in NOC cases

Ex-utero intrapartum treatment in the Indian scenario: Anesthetic challenges and positioning

Ex-utero intrapartum treatment (EXIT) is performed for fetuses diagnosed with large neck masses. A case report of a fetus diagnosed with a large cystic hygroma and cord around the neck who was delivered by EXIT is presented. The airway challenges and optimal positioning is discussed