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Gynecology Adnexal Mass
Gynecology Adnexal Mass
Gynecology Adnexal Mass
Ectopic Pregnancy
A complex cyst may simply be an ectopic pregnancy. In a
patient with a history of salpingitis where inflammation may
have created a stricture, fertilized eggs cannot pass. Ectopics
most commonly occur in the ampulla. This is a botched
pregnancy. The patient will present with amenorrhea
(pregnant), lower abdominal pain (as the cyst grows), and
vaginal spotting. The ultrasound will Risk of Ectopic: 1%
Risk with previous ectopic: 15%
Risk with previous ectopic with salpingostomy: 15%
Risk with previous ectopic with salpingectomy: 15%
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Gynecology [ADNEXAL MASS]
Tubo-ovarian Abscess
This is discussed in gyn infections. Essentially - repeated acute
PID (Gc/Chla) causes inflammation and allows the vaginal
flora to access the uterus, tubes, and ovary. One consequence is
abscess. The patient will present with a fever, leukocytosis, and
an adnexal mass. The sonogram will show said abscess. Treat it
with antibiotics x 72 hrs and continue if there’s improvement.
If not, the abscess needs to be drained. Indications to go to
emergent surgery for TOA is if the patient is very ill or if it’s
very large. TOA is one of the few abscess conditions that does
not require emergent drainage.
Ovarian Cancer
Any complex cyst can be cancer. Please see the Ovarian Cancer
section for details.
© OnlineMedEd. http://www.onlinemeded.org