Emergency Cases Northwest Group
012 Ovarian Oops
Situation
Patient diagnosed with appendicitis, but it was an infected ovarian
cyst
Background
A 45 year old lady presented with RIF pain, 1 day history. Tender,
guarding RIF on exam. WCC 22 CRP 190. No surgical or gynaecological
history at all. Referred surgeons as appendicitis. CT showed slightly
thickened appendix, in keeping with appendicitis. Laparoscopic surgery:
appendix was normal BUT obvious infected, purulent ovarian cyst so
gynaecology Spr called to take over in theatre.
Assessment
The infected ovarian cyst was mimicking appendicitis. The CT scan failed
to detect any ovarian pathology at all.
Recommendation
CT scans are not as sensitive to ovarian pathology as ultrasound.
So if you really want to exclude ovarian disease do an USS. The
exception is ovarian torsion where MRI is best.
PLEASE DO NOT INCLUDE ANY PATIENT IDENTIFIABLE DATA OR
GEO-LOCATION DATA IN THE SUBMISSION OR IN ANY ATTACHED
IMAGES
Emergency Cases Northwest Group