Gangrenous Omental Herniation Caused by Spontaneous Pouch of Douglas Fistula: A Rare Case
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Gangrenous Omental Herniation Caused by Spontaneous Pouch of Douglas Fistula: A Rare Case Arti Singh1 · Puneet Puri2 · Ashok Kr Singh3 Received: 31 March 2020 / Accepted: 2 September 2020 © Federation of Obstetric & Gynecological Societies of India 2020
Eighty-two-year-old female, multipara, presented with urosepsis. Pelvic assessment revealed foul-smelling, dirtylooking polypoidal mass protruding through vagina, which looked like a neoplastic lesion (Fig. 1). Ultrasound abdomen was normal, but MRI revealed omentum present in the Pouch of Douglas, protruding into the vagina through its posterior wall (Fig. 2a, b). During surgery omentum was dissected, necrotic part was excised and then reposited back into abdomen, followed by the closure of the defect in posterior vaginal wall. Histopathological examination revealed gangrenous omentum with no evidence of malignancy or granulomatous pathology. On follow-up, the patient was completely asymptomatic.
Dr. Arti Singh MS DNB, Consultant: Obstetrics and Gynecology, Regency Hospital Kanpur (UP), India; Dr. Puneet Puri MS, Mch, Consultant: Surgical Gastroenterology, Regency Hospital Kanpur (UP), India; Dr. Ashok Kr Singh MD, DNB, Consultant: Pulmonary and Critical Care Medicine, Regency Hospital Kanpur (UP), India.
Fig. 1 Dirty-looking polypoidal mass lesion protruding through the vagina
* Arti Singh [email protected] Puneet Puri [email protected] Ashok Kr Singh [email protected] 1
Obstetrics and Gynecology, Regency Hospital Kanpur, Kanpur, UP, India
2
Surgical Gastroenterology, Regency Hospital Kanpur, Kanpur, UP, India
3
Pulmonary and Critical Care Medicine, Regency Hospital Kanpur, Kanpur, UP, India
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Fig. 2 a, b MRI revealed omentum present in the Pouch of Douglas, protruding into the vagina through a rent in posterior vaginal wall Funding None.
About the Author
Compliance with Ethical standards Conflict of interest The authors declare that they have no conflict of interest. Informed Consent Informed consent was obtained from the patient.
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Arti Singh Dr. Arti Singh MS, DNB, is working as senior Consultant and Head of department Obstetrics and Gynecology, Regency Hospital, Kanpur, for the past 20 years. She has special interest in High Risk Pregnancies and Obstetric Critical Care Medicine. She has participated and organized various workshops, conferences, and CMEs at local and national level, and has many publications in national journals.
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