Acute Abdomen due to Mutual Tangle of Two Small Paratubal Cysts

Abstract EN

A 30-year-old woman (gravida 0) visited our hospital with a complaint of right lower abdominal pain.

Transvaginal ultrasonography revealed a 5-cm swollen right ovary, which was suspected to be a mature cystic teratoma.

Pelvic examination revealed moderate pain.

Contrast-enhanced computed tomography showed a 44-mm cystic mass containing fat and calcified material in the right pelvis.

Since torsion was suspected, emergent laparoscopic surgery was performed.

Intraoperative findings were a swollen right ovary without torsion or congestion.

Two small pedunculated 1- and 2-cm diameter paratubal cysts that grew from almost the same place of the ampulla of the right fallopian tube were observed.

The thin stalk of the 1-cm paratubal cyst was entangled around the stalk of the 2-cm paratubal cyst, with its head congested.

Through a small abdominal laparoscopic incision, the tumor of the right ovary and the two paratubal cysts were excised.

Histopathological examination revealed that the right ovarian tumor was a mature cystic teratoma, and the two paratubal cysts had no malignancy.

This case showed that only a 2-cm tumor with congestion caused the acute abdomen.