Decidualization of an ovarian endometrioma complicated by a sigmoid fistula during pregnancy: a case report
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(2020) 14:198
CASE REPORT
Open Access
Decidualization of an ovarian endometrioma complicated by a sigmoid fistula during pregnancy: a case report Hadiza Moutari Soule, Sofia Jayi, Tigani Guirema Madi, Alpha Boubacar Conte* , Fatima Zohra Fdili Alaoui, Hikmat Chaara and Moulay Abdelilah Melhouf
Abstract Background: During pregnancy, the discovery of adnexal masses remains frequent. Such masses are mostly benign. Ovarian endometrioma is a rare etiology. The diagnosis may be difficult in some situations, such as decidualization. It may be asymptomatic or result in complications for which magnetic resonance imaging is needed. Case presentation: We describe an unusual case of decidualization of an ovarian endometrioma complicated by a sigmoid fistula during a 7-week, 1-day pregnancy in a Arabic patient aged 38 years who developed acute pelvic pain with fever. She had a medical history of unexplored secondary dysmenorrhea. The diagnosis was suspected on the basis of magnetic resonance imaging findings. The management was based on surgery, during which exploration revealed a mass at the expense of the left ovary being very adherent and fistulized to the sigmoid. We performed adnexectomy followed by digestive ostomy. The result of pathological study with immunohistochemistry led to a diagnosis of decidualization of an ovarian endometrioma altered by infection. Conclusion: Decidualization of an ovarian endometrioma can lead sometimes to unexpected complications. The decision to provide surgery must be made with caution without delaying treatment in the event of a deep suspicion of malignancy and/or complication. The particular and exceptional complication discovered in our patient is the fistulization to the sigmoid. Keywords: Pregnancy, Endometrioma, Decidualization, Ostomy
Introduction Access to ultrasound at the beginning of pregnancy makes the association between pregnancy and adnexal mass an increasingly frequent situation [1]. Endometrioma is a rare and benign etiology of adnexal mass. Clinically, the endometrioma remains difficult to recognize because it presents with no specificity. However, its decidualization can lead to noisy complications. We report a rare case of a woman with a 7-week, 1-day * Correspondence: [email protected] Department of Gynecology - Obstetrics II, Hassan II Teaching Hospital, Sidi Mohamed Ben Abdellah University, Fez, Morocco
pregnancy with an ovarian endometrioma decidualized and fistulized to the sigmoid.
Case presentation Our patient was a 38-year-old pauciparous Arabic woman with a pregnancy of 7 weeks, 1 day gestation. She had consulted for acute pelvic pain of increasing intensity with fever without metrorrhagia and any other digestive or urinary signs. She had no specific medical or family history except a notion of unexplored secondary dysmenorrhea.
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long
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