Acil Serviste Postmenopozal Over Kist Torsiyonu: Olgu Sunumu
Özet
Over torsiyonu, overin kendi aksı etrafında kısmen ya da tamamen dönmesi sonucu gelişen, kanlanmanın bozulmasına bağlı iskemi ve nekroza ilerleyebilen jinekolojik bir acildir. Acil jinekolojik durumların yaklaşık %3’ünü over torsiyonu oluşturur ve olguların %80’inde başvuru sırasında eşlik eden bir over kitlesi bulunur. En sık üreme çağında görülebilmekle birlikte, postmenopozal kadınlarda görülme olasılığı üreme çağındaki kadınlara göre daha düşüktür. Kadının her yaşında over torsiyonunun klasik ders kitabı tanımlarında genellikle ‘üreme çağındaki kadında ani başlangıçlı pelvik ağrı’ klinik tablosu yer alsa da, gerçek hastalar çoğu zaman daha silik ve tanısal açıdan zorlayıcı semptomlarla başvurabilir; bu da tanıyı güçleştirebilir. Over torsiyonunun her yaşta görülebileceğini ve over tümörü ya da kist varlığının önemli bir risk faktörü oluşturduğunu ortaya koymak amacıyla, bu çalışmada over torsiyonu ile komplike olmuş, postmenopozal dönemde bulunması ve nonspesifik klinik bulguları nedeniyle özellikle acil tıp ve genel cerrahi birimleri açısından ayırıcı tanıda tanısal güçlük yaratan nadir bir olgu sunulmakta; acil servis yönetimi, tanısal yaklaşım ve cerrahi karar süreci literatür eşliğinde tartışılmaktadır.
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