Gebelikte Adneksiyal Kitleye Yaklaşım: Olgu Sunumu

Gebelikte saptanan adneksiyal kitle oranı ultrasonografinin rutin olarak kullanılmasından sonra artmıştır. Sıklıkla asemptomatik olan bu kitlelerin çoğunluğu benign olup, ilerleyen gebelik haftalarında özellikle ikinci trimesterde spontan rezolüsyona uğramaktadır. Bu kitlerlerden persiste olanların takip ve tedavisi zor olabilmektedir. Tedavi spekturumu konservatif yaklaşımdan komplike operasyonlara kadar çok geniş bir yelpaze sunmaktadır. Buna karşın günümüzde gebelikteki adneksiyel kitlelere yaklaşımda belirlenmiş altın standart bir tedavi şekli bulunmamaktadır. Olgu sunumumuzda rutin gebelik kontrolü sırasında akut batın tablosu ile başvuran ve laparoskopi ile tedavi edilen bir hastanın tanı, takip ve tedavisinin literatür verileriyle sunulması amaçlanmıştır.

Management of Adnexal Mass in Pregnancy: Case Report

The rate of an adnexal mass detected during pregnancy increased after the routine use of ultrasonography. There is no consensus on the approach to adnexal masses in pregnancy, which requires treatment in a wide spectrum from a conservative approach to complicated operations. These masses, which are frequently asymptomatic, are mostly benign and resolve spontaneously during the later weeks of pregnancy, especially in the second trimester, but persistent masses can be difficult to follow up and treat. Therefore, we examined the diagnosis, follow-up and treatment of adnexal masses during pregnancy, based on our patient who had a 15x13.5 cm well-defined cystic mass in the right adnexal area, which was detected incidentally at the first antenatal visit to our clinic, and who presented with acute abdomen during the follow-up and underwent an emergency operation.

___

  • 1. Ventolini G, Hunter L, Drollinger D, Hurd WW. Ovarian torsion during pregnancy. https://www.hcplive.com/view/2005-09_04. Date: 17.04.2022
  • 2. Lee CH, Raman S, Sivanesaratnam V. Torsion of ovarian tumors: a clinicopathological study. Int J Gynaecol Obstet. 1989;28:21–25.
  • 3. Yakasai IA, Bappa LA. Diagnosis and manage- ment of adnexal masses in pregnancy. J Surg Tech Case Rep.2012;4(2):79-85.
  • 4. Yen CF, Lin SL, Murk W, Wang CJ, Lee CL, Soong YK, Arici A. Risk analysis of torsion and malignancy for adnexal mases during pregnancy. Fertil Steril. 2009;91(5):1895–902.
  • 5. Whitecar MP, Turner S, Higby MK. Adnexal masses in pregnancy: A review of 130 cases undergoing surgical management. Am J Obstet Gynecol. 1999;181(1):19– 24.
  • 6. Schmeler KM, Mayo-smith WW, Peipert JF, Weitzen S, Manuel MD, Gordinier ME. Adnexal masses in pregnancy: surgery compared with observation. Obstet Gynecol. 2005;105:1098–103
  • 7. Duic Z, Kukura V, Ciglar S. Adnexal masses in pregnancy: a review of eight cases undergoing surgical management. Eur J Gynaecol Oncol. 2002;23:133–134.
  • 8. Hibbard LT. Adnexal torsion. Am J Obstet Gynecol. 1985;152:456–461.