Faculty:
Dr. Jaya Kumar Aggarwal (Consultant - Gynecology)
Dr. Sandeep Yadu (Sr. Consultant - Anesthesia)

Hospital:
RG Hospitals, East Of Kailash, New Delhi.

Presenting/Chief Complaints:
A 47 year old female presented with complaints of pain in the abdomen off and on for 6 months. She was having increasing abdominal distention and pain abdomen for 1 week. The patient also had history of hypertension for which she is under regular medication.

Provisional Diagnosis:
On further investigations USG Abdomen revealed a large abdomino pelvic complex cystic mass ? serous ovarian cyst adenoma.

Treatment/Procedure/Surgery:
Exploratory laparotomy + Adhesiolysis + Bilateral Salpingo oophorectomy under Spinal Anesthesia.

Operative Findings:
Intra operatively a large- 30cms gangrenous looking cystic mass was seen occupying the whole abdomen arising from the right ovary, along with three twists in the infundibulopelvic ligament of the right side. Incision was given on the cyst wall and 9.5 litrs of serosanguinous fluid was drained. Detwisting was done. Right tube along with large cyst was separated. Left salpingo oophorectomy also done.
Total duration of surgery – 1 hour.

Final Diagnosis:
Twisted Serous cyst adenoma of Ovary with Hypertension.

Course of Hospitalization and Condition of Patient at the Time of Discharge:
The patient responded well to the treatment and was discharged in a stable condition within 48 hours.