Luteal Cysts Research Articles

Laparotomy versus laparoscopy for the treatment of adnexal torsion during pregnancy

BackgroundAdnexal torsion (AT) is a rare emergency complication during pregnancy. Increasing evidence implies that operative laparoscopy for adnexal torsion performed during pregnancy could be safe and feasible. We procured and evaluated the surgical and obstetric outcomes between laparoscopy and laparotomy to determine the optimal approach for treating AT during pregnancy.MethodsThis was a retrospective study involving telephone questionnaire on adnexal torsion during pregnancy that occurred between July 2012 and July 2023 in the First Affiliated Hospital of Zhengzhou University. The study cohort included 155 pregnant women who underwent laparotomy or laparoscopic surgery. The clinical characteristics, surgical interventions, postoperative pathology and pregnancy outcomes were analyzed.ResultsA total of 102 patients were treated by laparoscopy, and 53 patients were treated by laparotomy. Compared with the laparotomy group, the laparoscopy group had significantly less blood loss (17.5 ml vs. 20.0 ml, p = .004), a lower incidence of delayed incision healing (1.0% vs. 11.3%, p = .011), and a shorter hospital stay (5.0 days vs. 8.0 days, p < .001). There was no significant difference between the two groups in terms of obstetric outcomes, including preterm delivery, miscarriage rate, birth weight, delivery gestation, cesarean delivery rate, or neonatal intensive care unit admission. All the pathological findings were benign except for one case of borderline mucinous cystadenoma. The most common pathological types were luteal cysts in the laparoscopy group and mature teratomas in the laparotomy group.ConclusionIn this retrospective study, compared with laparotomy, laparoscopy yielded successful outcomes, with less surgical bleeding, less delayed wound healing, and shorter hospital stays. Laparoscopy could be a promising approach for diagnosing and treating AT during pregnancy.

Tumor Markers in Differential Diagnosis of Benign Ovarian Masses.

Although there are many benign tumors in the ovarian adnexal area, the four most common types are still luteal cyst, ovarian mature cystic teratoma (OMCT), ovarian endometriosis, and benign epithelial tumors of the ovary. This study aimed to examine the correlation between six tumor markers (CEA, AFP, CA125, CA19-9, SCC, HE4) in the differential diagnosis of female adnexal benign masses and assess their diagnostic value. In this study, 135 patients with adnexal benign masses were treated in Zhengzhou first people's Hospital from January 2018 to January 2023. 135 patients were divided into four groups: luteal cyst (13.3%), OMCT (42.2%), ovarian endometriosis (23.7%) and benign epithelial tumors of the ovary (including mucinous cystadenoma and serous cystadenoma) in group D. The receiver-operating characteristic (ROC) curve was used to assess the diagnostic value of each marker and combined detection. The diameter of luteal cysts was significantly smaller than that of benign ovarian tumors (p < 0.001). ROC analysis showed that the combination of AFP, CA125, CA19-9, and SCC had a higher diagnostic rate for luteal cysts (AUC=0.871; sensitivity: 71.8%; specificity: 88.9). The SCC level in OMCT was significantly higher than in other benign ovarian tumors (p=0.007). ROC analysis indicated that the combination of AFP, HE4, and SCC had a higher diagnostic rate for OMCT (AUC=0.753; sensitivity: 65.4%; specificity: 75.4%). The CA125 level in ovarian endometriosis was significantly higher than in other accessory benign tumors (p < 0.001). ROC analysis demonstrated that the combination of AFP, CA125, and CA19-9 had a higher diagnostic rate for ovarian endometriosis (AUC=0.935; sensitivity: 76.7%; specificity: 96.9%). The tumor diameter of benign epithelial tumors of the ovary was significantly larger than that of other benign ovarian tumors (p < 0.001). ROC analysis revealed that the combination of CA125 and CA19-9 had a higher diagnostic rate for benign epithelial tumors of the ovary (AUC=0.792; sensitivity: 64.5%; specificity: 85.7%). The findings of this study demonstrate that the combined use of tumor markers (CEA, AFP, CA125, CA19-9, SCC, and HE4) has value in diagnosing benign ovarian tumors, including luteal cysts, OMCT, ovarian endometriosis, and benign epithelial tumors of the ovary. However, it is important to acknowledge the limitations of this study, which include its single-center nature and the small sample size. Despite these limitations, the results highlight the potential utility of these markers in clinical practice.

Haemorrhagic Corpus Luteal Cyst in a Young Female: A Case Report from Pakistan

The present case highlights the potential of misdiagnosis of functional cysts in young females presenting with acute abdominal pain and radiological findings consistent with other common gastrointestinal and urological disorders. A young female suffers bouts of acute abdominal pain. Initially, no radiological or clinical abnormalities were observed. Later, the patient developed signs of systemic infection and underwent two laparoscopic surgeries. Diagnosis of haemorrhagic corpus luteal cyst was established on histopathology. It is essential to thoroughly investigate acute abdominal pain as one of the differentials for ovarian cysts. Always consult a gynaecologist to rule out reproductive diseases in young females.

Assessment of Diverse Pelvic Pain in the First Trimester of Pregnancy with Ultrasound Guidance

Identifying and treating a pelvic pain during pregnancy can be challenging. Pregnant women still use ultrasound as their primary imaging modality. The current study set out to investigate the potential function of ultrasonography guidance in various pelvic pain sources during the first trimester of pregnancy. The Maternity and Children Hospital (MCH) and the Department of Radiology collaborated together to perform this cross-sectional descriptive study. 50 pregnant women, ages ranging from under 20 to over 30, who had pelvic pain throughout the first trimester (up to 12 weeks gestational age) participated in the study. All women had undergone clinical evaluations then to be referred for ultrasonography scans for the confirmation of diagnosis. SPSS software (version 25) was used to analyze the data and association using Odds ratio and multivariable logistic regression. In a study of 50 pregnant women with an assisted ultrasound. Among 22 (44%) and 28(56%) women were viable and non-viable pregnant. 60 percent of the women were primigravida, and 40 percent were multigravida. With a mean BMI of 28.7±4.21, the average age was 27.3±13.18 years. The most frequent causes of pelvic pain were abortion (22%), uterine fibroid (14%), and corpus luteal cyst (12%) in addition to Scar site pregnancy, Sub chorionic hematoma, ectopic pregnancy, and acute appendicitis were 8%,6%,6% and 1% respectively. whereas 30% of a normal pregnancy was found. The most reliable and non-invasive diagnostic technique for identifying various types of pelvic pain in pregnant women is ultrasound. It has been demonstrated that the timely treatment of women through the use of ultrasonography reduces the mortality rates linked with pregnancy problems.

Postpartum complications in cows: diagnosis, treatment, prevention

This review contains an analysis of domestic and foreign researchers regarding the occurrence of postpartum complications in cows, which represents a significant veterinary problem. Diagnostic methods and treatment regimens for postpartum pathologies of various origins are presented. Difficulties and errors in diagnosing uterine inflammation lead to improper treatment, prolonged infertility, and significant economic losses. Based on an analysis of the literature, it has been proven that clinical forms of endometritis often develop into a subclinical course. The proportion of hidden endometritis can account for up to 80 % of the total amount of endometrial inflammation. The problem with postpartum complications of the uterus is that the inflammatory processes spread to the ovaries, and this can lead to complete infertility in animals. Rectal examination of cows remains one of the primary methods for diagnosing endometritis. Treatment generally involves the use of a wide range of antibiotics. Data on the hormonal causes of postpartum pathologies of the reproductive system of cows are also presented. A big problem is follicular and luteal cysts, their timely diagnosis and appropriate treatment. The leading cause of cysts is a disruption of the hypothalamic-pituitary-gonadal axis. A practical method for diagnosing cysts is ultrasound, and the type of cyst can be determined by the level of progesterone in the blood. A practical method of treating cysts is the use of hormonal drugs. Data are also presented confirming the significant role of microflora in the occurrence of inflammatory changes in the reproductive organs of cows. The main types of causative agents of inflammatory processes in the genital organs of cows in the postpartum period are given. In cows with endometritis, an imbalance of the uterine microflora is detected, and the growth of bacteria of the genus Bacteroidetes and Fusobacteria with a simultaneous decrease in the number of Proteobacteria and Tenericutes. Data are presented that rumen acidosis can cause inflammation of the uterus, and this is associated with the penetration of Fusobacterium necrophorum into the blood circulation. The effectiveness of intravaginal treatment of cows with a mixture of lactic acid bacteria (L. rhamnosus, P. acidilactici, and L. reuteri) has been shown.

Ayurvedic Approach for Management of (Hemorrhagic Ovarian Cyst) Andashayagata Raktaja Granthi – A Case Report

Ovarian cysts can be either simple or complicated. Complex ovarian cysts contain either a solid or blood component. A common worry in standard gynecological care is ovarian cystic masses. The findings show that there are wide variations in the prevalence of ovarian cysts. Reports state that 8–18% of post-menopausal and pre-menopausal women have ovarian cysts. Most cysts are asymptomatic and can only be detected by routine ultrasonography. Certain ones are very symptomatic, posing challenges for women in their day-to-day activities. The symptoms are significantly influenced by the size of the cysts. A closed, sac-like structure on or inside the ovary that is filled with a liquid or semi-solid material is called an ovarian cyst. A type of functional cyst known as a hemorrhagic cyst is often referred to as a corpus luteal cyst. Treatment options for cysts that do not go away after 3 months include surgery and a combination of oral contraceptive tablets. The need for alternative kinds of management is increasing as a result of the many adverse effects of oral contraceptives, especially for individuals who would rather not have surgery. Treatment for a 22-year-old female patient who had a complicated right ovarian hemorrhagic cyst with dyspareunia, burning micturition, and significant lower abdominal pain was based on Ayurvedic principles. For one and half months, the patient was administered Gandharva Hastadi Tail, Kachnara Gugglu, Arbudhara Kwatha katuki Churna, Chandanasava, Amrutoz, Dhatriloha, and Sankha Bhasm. A follow-up USG revealed that the hemorrhagic cyst had completely disappeared and that the symptoms had much decreased. The current study highlights how Ayurveda can help control ovarian cysts in a way that is beneficial.

Corpus luteal cyst rupture presenting as massive spontaneous hemoperitoneum in women with dengue infection: A case series

Corpus luteal cyst rupture presents with acute pain abdomen, hemoperitoneum and features of shock. The condition clinically closely mimics acute rupture ectopic pregnancy but has negative urine pregnancy test. Massive hemoperitoneum requires urgent surgical exploration and achievement of hemostasis. Here is a case series describing 3 cases of corpus luteal cyst rupture in patients with diagnosed dengue fever presenting with features of acute abdomen with or without shock at emergency. All were managed surgically, did well in postoperative period, had transfusions of blood and blood products and finally discharged in satisfactory condition. The objective of this series is to highlight the importance of this condition as a differential diagnosis in patients with acute abdomen which is not much described in medical literature.

Effect of Double-Ovsynch and Presynch-Ovsynch on postpartum ovarian cysts and inactive ovary in high-yielding dairy cows.

Optimizing the management of dairy cattle reproduction can reduce postpartum ovarian disease in high-yielding dairy cows and thus enhance ranch economic benefit. The hypothesis of this study was that the Double-Ovsynch (DO) protocol in high-producing dairy cows would result in a lower incidence of follicular cysts but a higher incidence of luteal cysts compared to those undergoing the Presynch-Ovsynch (PS) protocol. In this experiment, 384 cows (204 primiparous and 180 multiparous) were allocated to the DO group, which followed the protocol: GnRH-7d-PGF2α-3d-GnRH-7d-Ovsynch-56 h (GnRH-7d-PGF2α-56 h-GnRH-16hTAI), starting on 39 ± 3 days in milk (DIM). Additionally, 359 cows (176 primiparous and 183 multiparous) were assigned to the PS group, which followed the protocol: PGF2α-14d-PGF2α-12d-Ovsynch-56 h, starting on 31 ± 3 DIM. In DO, B-mode ultrasound examinations were conducted 1 day after the GnRH-7d-PGF2α-3d-GnRH protocol to diagnose the presence of ovarian diseases followed by reexamination after 7 days of suspected cases. In PS, B-mode ultrasound examinations were conducted 1 day after the PGF2α-14d-PGF2α protocol to diagnose the presence of ovarian diseases followed by reexamination after 7 days. For all cows confirmed to having ovarian diseases, a second B-mode ultrasound examination was conducted at the time of the second GnRH and timed artificial insemination (TAI). If the ovary showed a normal developing follicle in combination with normal ovulation, the ovarian disease was considered to be cured. The current study revealed no significant difference in the overall incidence and cure rate of postpartum ovarian diseases between DO and PS (incidence rate: 3.9% vs. 6.7%, cure rate: 50% vs. 41.7%, DO vs. PS). Also, there was no significant difference in the incidence and cure rate of luteal cysts between DO and PS (incidence rate: 2.9% vs. 2.2%, cure rate: 50.0% vs. 50.0%). The incidence of follicular cysts was significantly lower in the DO group than in the PS group (0.8% vs. 2.8%, DO vs. PS, p = 0.037), but there was no significant difference in the cure rates (66.7% vs. 50%). The occurrence of inactive ovary was lower in DO compared to PS (0.2% vs. 1.7%, p = 0.047). There was no significant difference in the pregnancy rate between the DO and PS groups (48.2% vs. 41.8%), although the DO group had a higher rate. What is different from our assumption is that PS did not effectively reduce the incidence of postpartum luteal cysts.

Histopathological Study of Ovarian Cysts in Derna

Ovarian cysts, which are sacs filled with fluid located in the ovaries, represent the primary reason for enlarged ovaries, impacting approximately 20% of women who experience a pelvic mass at least once during their lifetime. The present work was carried out to focus on the frequency, gross appearance and histopathological features of each type of ovarian cysts in Derna-City East of Libya. This work included 54 cases of ovarian cysts, out of 338 samples submitted to Noor-AL-Huda Medical Center Pathology Laboratory in Derna City –East of Libya during the period between January 2022 and April 2023, samples were formalin fixed, processed, then H &amp;E sections were obtained for histologic diagnosis and subtyping. The age of patients ranges from 5 – 68 years, the predominant age group was 30– 39 years, 26 (48.14%) were on the right side, 23(42.59%) were on the left side, 5(9.25%) were bilateral. The commonest presenting symptoms were both incidental in 21(38.8%) and pain in 18(33.33%); the cyst mainly obtained from Cystectomy operation 39 (72.22%). Gross appearance of each type was studied. Out of the included 54 ovarian cysts 29 (53.70%) were non –neoplastic and25 (46.29%) were neoplastic. Follicle cysts represented (37.93%) of the non-neoplastic lesions, while serous cyst adenoma represented (40%) of the neoplastic lesions. We concluded that non-neoplastic cysts are the most common types of ovarian cysts. Among non-neoplastic ovarian cysts, the functional cysts including follicular and corpus luteal cysts were the most common, while serous cysts and teratomas are the common neoplastic cysts. Most ovarian cysts are found on the right side. Histopathological examination is essential for accurate diagnosis and proper management of ovarian cysts.

Cystic ovary disease (COD) alters structure and function of the bovine oviduct.

Cystic ovary disease (COD) is a common cause of subfertility in dairy cattle. Therefore, the aim of this study was to provide novel concepts for cyst classification and to investigate the effects of COD on tubal microarchitecture, oviductal metabolic function, and the formation of the sperm reservoir. Bovine Fallopian tubes affected by follicular cysts, follicular cysts with luteinization and luteal cysts were investigated by a variety of microscopic and histological techniques and compared to control cows in metestrus and diestrus. We defined three types of cysts involved in COD, each of which had a characteristic wall thickness, inner wall appearance and cellular pattern within the cyst aspirate. Regarding the Fallopian tube, each cyst type was associated with a characteristic morphology, specifically the microarchitecture of the folds in ampulla, epithelial cell ratios, and ciliated/secretory cell size and form. Furthermore, each cyst type showed different patterns of tubal glycoprotein and acidic mucopolysaccharide synthesis, which was highly variable as compared to the controls. Our studies are the first to characterize the effects of COD on the Fallopian tube, which promotes the establishment of novel, cyst-specific therapeutic concepts in cattle and helps gain a holistic view of the causes of subfertility in cows with COD.

Prevalence of female genital tract disorders of ovaries and fallopian tubes in one-humped camels in Maiduguri, Nigeria using abattoir samples

The present study examined a total of one hundred and fifty (150) genital tracts of female dromedary camels (Camelus dromedarius) in Maiduguri abattoir for ovarian and fallopian tube disorders and different pathological lesions recorded were 27 cases, equivalent to 18.0% prevalence. Assessment and measurement of the genital tracts identified obvious gross lesions based on appearances, type of lesion, location and frequency of occurrence. Luteal cysts, catarrhal salphingitis, hemorrhagic cyst, ovarian hydro-bursitis and suspected case of granulosa cell tumour were detected. Follicular tube cysts both as unilateral and bilateral and as singles or multiples were also detected. Four of the cysts were observed on the left ovary, one on the right ovary and a multifocal was observed on both ovaries. The luteal cysts were thick walled. The luteal cysts were mostly seen in the left ovary representing 12 of the 16 cases while the remaining 4 cases were associated with the right ovary. A case of hemorrhagic cyst was recorded. Ovarian hydro-bursitis was recorded as a single case. A suspected granulosa cell tumor was observed in the left ovary. The study affirmed that ovarian and fallopian tube abnormalities are common findings in one-humped female camels although camels can withstand lots of stress associated with infectious and non-infectious diseases. These pathologies are possible causes of reduced fertility in one-humped camel in the study area.

Use of contraceptives in cats with ovarian and uterine pathology

Regulation of the reproductive capacity of cats using megestrol acetate (a gestagenic preparation) contributes to the development of pathological processes in the uterus, ovaries, and imbalance of gonadal hormones. Therefore, it is essential to investigate and scientifically substantiate the pathogenetic processes in the body of cats under medical contraception. The purpose of this study was to substantiate the pathomorphological changes and dynamics of certain blood parameters in the body of cats under the use of megestrol acetate. The study employed clinical (examination, palpation), laboratory (haematological, biochemical, hormonal), morphological (examination of the genital organs of cats amputated during ovariohysterectomy) methods. A decrease in ovarian size in hypotrophic cats by 11.3×9.05% was found compared to the ovaries of healthy cats. The dependence of megestrol acetate administration on the occurrence of cystic formations in the ovaries was found, with an increase in ovaries in the experimental group by 1.7×2.47 times in follicular cysts and by 1.9×3.1 and 2.5×3.9 times in luteal cysts and polycystic cysts, respectively. It was found that the uterus in cats with megestrol acetate was increased by 3.16×1.93 times in the right horn and 2.84×2.1 times in the left horn compared to the uterus of healthy cats. The dynamics of progesterone (increase by 37.85%), follicle-stimulating hormone (decrease by 43.75%) and oestradiol (increase by 72.15%) were determined in comparison with intact animals. The increase in serum glucose levels in cats after megestrol administration by 34.31%, total protein by 25.0% and creatinine by 11.10%, aspartate aminotransferase by 43.84% (1.78 times) and alanine aminotransferase by 49.84% (1.99 times), and serum urea by 58.71% was substantiated. At the same time, haemoglobin levels decreased by 16.5%. The findings of this study can be used in the development of new methods and regimens of medical contraception with minimisation of risks of complications of the reproductive system, regulation of reproductive capacity, and prevention of infertility in cats

The course of the postpartum period in cows in the presence of concomitant pathology

The decrease in productivity in cows is directly related to the pathologies of the organs of the reproductive system that occur at the end of the transit period, therefore it is important to improve the methods of diagnosis and preventive therapy of cows in this period. The purpose of the work was to establish the forms of pathologies that occur in the transit period in cows, their interrelationship and the causes that cause them in terms of seasonal dynamics. When conducting research, morphological, clinical (examination, palpation), laboratory (bacteriological studies of the uterus), and statistical (statistical reliability) methods were used. The research was conducted in the limited liability company “Milk of the Fatherland” in 2 departments where unattached housing is used. The occurrence of subinvolution of the uterus against the background of litter retention and persistent corpus luteum was established by 9.5% more in the 1st department. A 43.5% correlation of the prevalence of delayed involution with endometritis was revealed. An increase, 12.8% in January and up to 14.1 in February, of cases of subinvolution of the uterus was established, while in May the similar indicator was 5.0%. The prevalence of persistent corpus luteum was established up to 16.8%, luteal cyst – up to 1.7%, ovarian follicular cyst – 2.1%. The presence of microflora in the uterine cavity (E. coli, Ps. aeruginosa and S. aureus – 49.8% S. aureus and E. coli – 33.5%, Pr. vulgaris and E. coli – 16.7%) provoked the occurrence inflammatory processes: chronic endometritis – 10.4%, vulvovaginitis – 18.1%, cervicitis – 21.4%. Research results can be used to develop new and improve existing methods of treatment of cows with pathology of genital organs in the transit period in farms of different forms of ownership

Transcriptome and Metabolome Analyses Reveal the Mechanism of Corpus Luteum Cyst Formation in Pigs.

Corpus luteum cysts are a serious reproductive disorder that affects the reproductive performance of sows. In this study, transcriptome and metabolome datasets of porcine normal and cyst luteal granulosa cells were generated to explore the molecular mechanism of luteal cyst formation. We obtained 28.9 Gb of high-quality transcriptome data from luteum tissue samples and identified 1048 significantly differentially expressed genes between the cyst and normal corpus luteum samples. Most of the differentially expressed genes were involved in cancer and immune signaling pathways. Furthermore, 22,622 information-containing positive and negative ions were obtained through gas chromatography-mass spectrometry, and 1106 metabolites were successfully annotated. Important differentially abundant metabolites and pathways were identified, among which abnormal lipid and choline metabolism were involved in the formation of luteal cysts. The relationships between granulosa cells of luteal cysts and cancer, immune-related signaling pathways, and abnormalities of lipid and choline metabolism were elaborated, providing new entry points for studying the pathogenesis of porcine luteal cysts.

Management of ovarian ectopic pregnancy: a case report

An ectopic pregnancy occurs when a developing blastocyst implants at places other than the uterine cavity. An incidence of ovarian implantation is 1 in 7000 to 40000 live birth and 0.5 to 3 % of all ectopic pregnancies. If ruptured, it is a life-threatening condition. We report a case of 30-year-oldmultiparous (G3P2L2) female who presented to us with chronic lower abdominal pain and irregular per-vaginal bleeding. She was diagnosed with differential ruptured ovarian pregnancy and a corpus luteal cyst on her left side and underwent laparotomy. During laparotomy, the diagnosis was confirmed to be left ruptured ovarian pregnancy which was later confirmed by the histopathological report. She underwent left-sided oophorectomy with preservation of the fallopian tube as it was normal.

A histopathological study of ovarian lesions in a rural medical college

Ovarian lesions can present in any age of life and has a wide spectrum of presentation. They contribute to most of the pelvic masses encountered in clinical practice in reproductive age group. Histopathological examination is of prime importance in ovarian lesions as it is difficult to diagnose these lesions on basis of clinical history, radiology alone.: To analyse the spectrum of ovarian lesions and to categorize them on basis of histomorphological pattern. A total 132 cases were studied from January 2022 to December 2022. Relevant clinical details and histopathological findings were reviewed and analysed. A total of 132 cases of ovarian lesions were included in this study with age range from 20 years to 72 years. Non neoplastic cases were 71 and neoplastic cases were 61 in present study. Follicular cyst was the commonest non neoplastic lesion (48 cases) followed by haemorrhagic corpus luteal cyst (16 cases). Out of 61 neoplastic lesions, 56 were benign, 3 were borderline and 2 were malignant on histopathological examination. Mucinous cystadenoma was the commonest benign lesion and serous cystadenocarcinoma was the commonest malignant tumour in the present study. Borderline mucinous cyst adenoma was the commonest in borderline cases in our study. Unilateral presentation of ovarian lesions was found in 116 cases and bilateral in 16 cases. In present study majority of cases were of non neoplastic lesions. For accurate management of the ovarian lesions it is important to correlate clinical findings and ultrasonography findings with histopathology diagnosis.

Acute Abdominal Pain Caused by Hemorrhagic Corpus Lutheum in Reproductive-Aged Women: A Case Series

Hemorrhage of corpus luteum is a rare condition in women of reproductive age. It is possible for a woman's corpus luteum to have asymptomatic hemorrhaging as a result of blood vessel penetration through the wall of the corpus luteum during the second half of her menstrual cycle. There have been very few occurrences of it growing to be too large and then rupturing. Those who suffer from polycystic ovarian syndrome (PCOS) are at risk for developing this condition. Polycystic ovarian syndrome is characterized by an inflammation of the body's hormonal function, which results in the development of larger ovaries that also include a number of small follicular cysts. The development of cysts on the ovaries, which contribute to the appearance of larger ovaries, is brought on by an abundance of androgen hormones in the body. In a minority of cases, this enlargement also has the potential to rupture, which is an additional concern. The predominant symptom that presented clinically was sharp pain in the lower abdomen. Because to the fact that HCL may present similarly to other conditions, diagnosis might be difficult. We present and discuss three cases of young female patients who presented with acute abdominal pain, large-volume of hemoperitoneum, and anemia. Laparoscopic examination in each case showed a hemorrhagic corpus luteal cyst.

Case Report of Warfarin Induced Hemoperitoneum

Although spontaneous hemoperitoneum is a rare condition, it has the potential to be devastating. A common coumarin anti-coagulant used for therapeutic and preventive anticoagulation is warfarin. Despite being a drug that can save lives, it is linked to severe side effects, mainly bleeding. The aim and objective of the study include the unusual occurrence of Hemoperitoneum that an Anti-Coagulant Drug Warfarin induces. Although reports of spontaneous hemoperitoneum in anticoagulant-using individuals have been published in the literature, diagnostic standards and therapeutic approaches have not yet been firmly established. PT INR should be routinely checked when warfarin is prescribed to prevent any problems. Intraabdominal bleeding resulting from non-traumatic reasons or organ rupture within the abdomen is known as spontaneous hemoperitoneum. The presence of intra-abdominal bleeding from a non-traumatic origin is known as spontaneous hemoperitoneum. Hemoperitoneum from warfarin is a known side effect that can be fatal. It might be challenging to manage unexpected bleeding while keeping the INR under control and preventing thrombosis. If the INR is out of range, there is a higher risk of warfarin-induced bleeding. The spontaneous hemoperitoneum described in this case report was caused by warfarin over-toxicity in a patient with rheumatic heart disease. The indications and symptoms resemble a ruptured corpus luteal cyst or an ectopic pregnancy. Although the patients undergoing Anti-coagulant therapy, especially warfarin, may experience other symptoms like GI bleeding, Nausea, Hematuria and so on.

Cystic ovarian disease in dairy cattle: Diagnostic accuracy when using B-mode and color Doppler ultrasound

The most frequently reported definition of cystic ovarian disease in cattle is an abnormally persistent follicle (>7 to 10 d) with a diameter >25 mm. Discrimination between luteal and follicular ovarian cystic structures has traditionally been conducted by measuring the rim width of luteal tissue. The most common practice used in the field for diagnosis of cystic ovarian disease is examination by rectal palpation with or without the use of a B-mode ultrasound. Color Doppler ultrasound technology allows assessment of blood flow area measurements in the ovary, which has been proposed as a potential indirect measure for plasma progesterone (P4) concentrations. The objective of this study was to compare the diagnostic accuracy of differentiating luteal structures from follicular ovarian cysts using measures collected with B-mode and color Doppler transrectal ultrasonography. The definition of an ovarian cyst was a follicle greater than 20 mm in diameter in the absence of a corpus luteum that persisted for at least 10 d. A 3-mm luteal rim width was used to differentiate follicular and luteal cysts. A total of 36 cows were enrolled in the study during routine herd reproductive examination visits, with 26 and 10 having follicular and luteal cysts, respectively. Cows enrolled in the study were examined using a Mini-ExaPad mini ultrasound with color Doppler capabilities (IMV Imaging Ltd.). Blood samples were collected from each cow to measure P4 serum concentrations. History and signalment of each cow, including days in milk, lactation, times bred, days since last heat, milk composition, and somatic cell counts, were retrieved from an online database (DairyComp 305, Valley Agricultural Software). The accuracy of diagnosing follicular from luteal cysts based on luteal rim thickness was analyzed by receiver operating characteristic (ROC) curve using P4 as the gold standard, where P4 concentrations exceeding 1 ng/mL was defined as luteal, and all other structures with less P4 were considered follicular. Luteal rim and blood flow area were selected for further analysis because they presented the best ROC curves for differentiating cystic ovarian structures, with areas under the curve of 0.80 and 0.76, respectively. Luteal rim width of 3 mm was used as the cutoff standard in the study, resulting in sensitivity and specificity of 50% and 86%, respectively. Blood flow area of 0.19 cm2 was used as the cutoff standard in the study, resulting in sensitivity and specificity of 79% and 86%, respectively. When combining the use of luteal rim width and blood flow area to differentiate cystic ovarian structures, a parallel approach resulted in sensitivity and specificity of 73% and 93%, respectively, whereas an in-series approach resulted in sensitivity and specificity of 35% and 100%, respectively. In conclusion, the use of color Doppler ultrasonography when discriminating between luteal and follicular ovarian cysts in dairy cattle resulted in higher diagnostic accuracy compared with using B-mode ultrasonography alone.

A RETROSPECTIVE STUDY OF OVARIAN TUMOURS AMONG PATIENTS ADMITTED IN A TERTIARY CARE HOSPITAL

Introduction: Ovarian tumours are a group of neoplasms affecting the ovary and have diverse spectrum of features according to particular tumour entity. Cystic lesions of ovary may be non-neoplastic (physiological) or neoplastic (pathological). Pelvic Ultrasonography is commonly used to detect and distinguish between benign and malignant masses and combined clinical and ultrasonography has increased sensitivity and specicity for diagnosis of tumours. Histopathological examination is the gold standard for distinguishing between benign and malignant tumours. RMI helps in preliminary evaluation of all ovarian masses and assist in reducing mortality and morbidity of patients with ovarian carcinoma. Objective: To evaluate the ovarian masses according to frequency, age wise distribution and correlate clinical and radiological ndings with histopathological diagnosis and to correlate RMI score with histopathological diagnosis. Materials and Methods:It is a retrospective study conducted at Dr. PSIMS &amp; RF from December 2021 to December 2022 and includes 50 cases of ovarian lesions who underwent surgery. Clinical, radiological ndings were collected and RMI score was calculated and correlated with Histopathological analysis. Results : Out of 50 cases, 27 cases were Non- neoplastic lesions and 23 cases were neoplastic. Among 23 Neoplastic lesions, 21 were benign tumours, 2 were Malignant tumours. Maximum number of ovarian masses were reported at 41-50 years (11 non- neoplastic lesions and 8 benign ovarian tumours) followed by 31-40 years of age. The most common non- neoplastic lesion was corpus luteal cyst (32%) and Serous cystadenoma was the commonest benign lesion (30%). The most common presenting complaint was abdominal pain (54%) followed by menstrual disturbances (20%). Combined use of clinical and USG has similar sensitivity as RMI score in differentiating benign and malignant lesions. Conclusion: Histopathological diagnosis plays a major role in diagnosis and sub categorization of ovarian lesions, thereby aiding better clinical outcome. Calculation of RMI is the best method and the most reliable tool for dening subsequent diagnostic, management and therapeutic strategies for benign and malignant ovarian masses.