Paraovarian Cyst Strangulation Caused by the Entanglement of Multiple Paraovarian Cysts: A Case Report

Abstract

An 11-year-old girl with fever, right lower abdominal pain, and vomiting was referred to our hospital. Blood examination revealed mildly elevated inflammatory markers, and computed tomography revealed a small amount of ascites in the pelvic cavity. The appendix was slightly enlarged, and the lumen was found to contain retained fecal matter. Diagnostic laparoscopy revealed three small pedunculated and paraovarian cysts in the right fallopian tube. A pedunculated and subpedunculated cyst, along with part of the fallopian tube, were intertwined and compressed. However, no fallopian tube torsion was present. The compression was relieved, and the cysts were resected by laparoscopic surgery. Similar cysts were also present in the left fallopian tube, which were cauterized and the contents aspirated and removed. The appendix showed no signs of inflammation and was therefore not resected. Acute abdominal pain due to gynecological disorders such as large paraovarian cysts with tubal torsion is relatively common, however, cases involving multiple small entangled and compressed paraovarian cysts without tubal torsion are extremely rare.