Rüptüre Over Kistlerinin Yönetimi
Özet
Over kist rüptürü, en sık görülen jinekolojik acillerden biridir. Tanısında fizik muayene bulguları, detaylı anamnez, laboratuvar bulguları ve görüntüleme yöntemleri önemli yer tutmaktadır. Ayırıcı tanıları son derece çeşitlidir, jinekolojik ve non-jinekolojik süreçleri içerir. Mutlaka detaylı incelenmeli, tanısı acil ve doğru bir şekilde konmalıdır. Hemodinamik olarak stabil olmayan hastalarda, persiste eden ciddi kanama varsa cerrahi önemli bir seçenektir. İlk basamakta laparoskopi tercih edilmeli ancak uygun olmayan durumlar varsa laparotomiye geçilmelidir. Hastann over rezervi, mevcut durumu ve doğurganlık planına göre cerrahi plan yapılmalıdır. Hemodinamisi stabil olan, ancak anemi bulgularının eşlik ettiği kendini sınırlamış hematom alanının görüldüğü durumlarda kan transfüzyonu hayat kurtarıcı olabilmektedir. Bu durumlar dışında hastaların çoğu cerrahi ve transfüzyona gerek kalmadan takip, gözlem ve basit analjezi ile tedavi edilirler. Gebe hastalarda, daha çok konservatif yaklaşım tercih edilse de cerrahi endikasyonu doğarsa tercih laparoskopi yönünde olmalıdır.
Referanslar
Abduljabbar HS, Bukhari YA, Al Hachim EG, et al. Review of 244 cases of ovarian cysts. Saudi Medical Journal [Internet]. 2015 Jul 6 [cited 2023 Mar 13];36(7):834–8. Available from: https://pubmed.ncbi.nlm.nih.gov/26108588/
Raziel A, Ron-El R, Pansky M, et al. Current management of ruptured corpus luteum. European Journal of Obstetrics Gynecology and Reproductive Biology [Internet]. 1993 [cited 2023 Mar 13];50(1):77–81. Available from: https://pubmed.ncbi.nlm.nih.gov/8365540/
Kim JH, Lee SM, Lee JH, et al. Successful conservative management of ruptured ovarian cysts with hemoperitoneum in healthy women. Public Library of Science One [Internet]. 2014 Mar 7 [cited 2023 Mar 13];9(3). Available from: https://pubmed.ncbi.nlm.nih.gov/24608424/
Jansen RPS. Relative bradycardia: a sign of acute intraperitoneal bleeding. The Australian and New Zealand Journal of Obstetrics and Gynaecology [Internet]. 1978 [cited 2023 Mar 13];18(3):206–8. Available from: https://pubmed.ncbi.nlm.nih.gov/283785/
Adams SL, Greene JS. Absence of a tachycardic response to intraperitoneal hemorrhage. Journal of Emergency Medicine [Internet]. 1986 [cited 2023 Mar 13];4(5):383–9. Available from: https://pubmed.ncbi.nlm.nih.gov/3805695/
Uharček P, Mlynček M, Ravinger J. Elevation of serum CA 125 and D-dimer levels associated with rupture of ovarian endometrioma. The International Journal of Biological Markers [Internet]. 2007 Jul [cited 2023 Mar 13];22(3):203–5. Available from: https://pubmed.ncbi.nlm.nih.gov/17922464/
Shah V, Stanislavsky A. Ruptured corpus luteum with large haemoperitoneum. Radiopaedia.org [Internet]. 2011 Apr 17 [cited 2023 Mar 13]; Available from: http://radiopaedia.org/cases/ruptured-corpus-luteum-with-large-haemoperitoneum
Teng SW, Tseng JY, Chang CK, et al. Comparison of laparoscopy and laparotomy in managing hemodynamically stable patients with ruptured corpus luteum with hemoperitoneum The Journal of the American Association of Gynecologic Laparoscopists [Internet]. 2003 [cited 2023 Mar 13];10(4):474–7. Available from: https://pubmed.ncbi.nlm.nih.gov/14738631/
Clément D, Barranger E, Benchimol Y, et al. Chemical peritonitis: a rare complication of an iatrogenic ovarian dermoid cyst rupture. Surgicial Endoscopy. 2003;17(4):658.
Shamshirsaz AA, Shamshirsaz AA, Vibhakar l. J, Broadwell C, van Voorhis BJ. Laparoscopic management of chemical peritonitis caused by dermoid cyst spillage. Journal of the Society of Laparoscopic and Robotic Surgeons [Internet]. 2011 Jul [cited 2023 Mar 13];15(3):403–5. Available from: https://pubmed.ncbi.nlm.nih.gov/21985734/
Reif P, Schöll W, Klaritsch P, et al. Rupture of endometriotic ovarian cyst causes acute hemoperitoneum in twin pregnancy. Fertility Sterility [Internet]. 2011 [cited 2023 Mar 13];95(6):2125.e1-2125.e3. Available from: https://pubmed.ncbi.nlm.nih.gov/21315338/
Crétel E, Cacoub P, Gompel A, et al. Ovarian hemorrhage with hemoperitoneum leads to complication of oral treatment using indirect anticoagulant administered by the oral route. Revue de Medecine Internet. 2000;21(5):428–34.
Chen L, Ding J, Hua KQ. Comparative analysis of laparoscopy versus laparotomy in the management of ovarian cyst during pregnancy. Journal of Obstetrics and Gynaecology Research [Internet]. 2014 [cited 2023 Mar 13];40(3):763–9. Available from: https://pubmed.ncbi.nlm.nih.gov/24738121/
Referanslar
Abduljabbar HS, Bukhari YA, Al Hachim EG, et al. Review of 244 cases of ovarian cysts. Saudi Medical Journal [Internet]. 2015 Jul 6 [cited 2023 Mar 13];36(7):834–8. Available from: https://pubmed.ncbi.nlm.nih.gov/26108588/
Raziel A, Ron-El R, Pansky M, et al. Current management of ruptured corpus luteum. European Journal of Obstetrics Gynecology and Reproductive Biology [Internet]. 1993 [cited 2023 Mar 13];50(1):77–81. Available from: https://pubmed.ncbi.nlm.nih.gov/8365540/
Kim JH, Lee SM, Lee JH, et al. Successful conservative management of ruptured ovarian cysts with hemoperitoneum in healthy women. Public Library of Science One [Internet]. 2014 Mar 7 [cited 2023 Mar 13];9(3). Available from: https://pubmed.ncbi.nlm.nih.gov/24608424/
Jansen RPS. Relative bradycardia: a sign of acute intraperitoneal bleeding. The Australian and New Zealand Journal of Obstetrics and Gynaecology [Internet]. 1978 [cited 2023 Mar 13];18(3):206–8. Available from: https://pubmed.ncbi.nlm.nih.gov/283785/
Adams SL, Greene JS. Absence of a tachycardic response to intraperitoneal hemorrhage. Journal of Emergency Medicine [Internet]. 1986 [cited 2023 Mar 13];4(5):383–9. Available from: https://pubmed.ncbi.nlm.nih.gov/3805695/
Uharček P, Mlynček M, Ravinger J. Elevation of serum CA 125 and D-dimer levels associated with rupture of ovarian endometrioma. The International Journal of Biological Markers [Internet]. 2007 Jul [cited 2023 Mar 13];22(3):203–5. Available from: https://pubmed.ncbi.nlm.nih.gov/17922464/
Shah V, Stanislavsky A. Ruptured corpus luteum with large haemoperitoneum. Radiopaedia.org [Internet]. 2011 Apr 17 [cited 2023 Mar 13]; Available from: http://radiopaedia.org/cases/ruptured-corpus-luteum-with-large-haemoperitoneum
Teng SW, Tseng JY, Chang CK, et al. Comparison of laparoscopy and laparotomy in managing hemodynamically stable patients with ruptured corpus luteum with hemoperitoneum The Journal of the American Association of Gynecologic Laparoscopists [Internet]. 2003 [cited 2023 Mar 13];10(4):474–7. Available from: https://pubmed.ncbi.nlm.nih.gov/14738631/
Clément D, Barranger E, Benchimol Y, et al. Chemical peritonitis: a rare complication of an iatrogenic ovarian dermoid cyst rupture. Surgicial Endoscopy. 2003;17(4):658.
Shamshirsaz AA, Shamshirsaz AA, Vibhakar l. J, Broadwell C, van Voorhis BJ. Laparoscopic management of chemical peritonitis caused by dermoid cyst spillage. Journal of the Society of Laparoscopic and Robotic Surgeons [Internet]. 2011 Jul [cited 2023 Mar 13];15(3):403–5. Available from: https://pubmed.ncbi.nlm.nih.gov/21985734/
Reif P, Schöll W, Klaritsch P, et al. Rupture of endometriotic ovarian cyst causes acute hemoperitoneum in twin pregnancy. Fertility Sterility [Internet]. 2011 [cited 2023 Mar 13];95(6):2125.e1-2125.e3. Available from: https://pubmed.ncbi.nlm.nih.gov/21315338/
Crétel E, Cacoub P, Gompel A, et al. Ovarian hemorrhage with hemoperitoneum leads to complication of oral treatment using indirect anticoagulant administered by the oral route. Revue de Medecine Internet. 2000;21(5):428–34.
Chen L, Ding J, Hua KQ. Comparative analysis of laparoscopy versus laparotomy in the management of ovarian cyst during pregnancy. Journal of Obstetrics and Gynaecology Research [Internet]. 2014 [cited 2023 Mar 13];40(3):763–9. Available from: https://pubmed.ncbi.nlm.nih.gov/24738121/
