2020 Volume 56 Issue 3 Pages 309-313
The patient was a 13-year-old female who visited a local doctor with complaints of abdominal pain. Subsequently, she was referred to our hospital where an ovarian cyst was detected. However, the reported pain was located in the right upper abdomen, where an abdominal mass was also detected. Therefore, she underwent abdominal ultrasound and computed tomography examination. In the right upper abdomen, there was a multilocular cyst with a high echo (~90 mm) were detected. Moreover, a 115-mm-diameter single cyst was also found in the pelvis. In addition, the levels of inflammatory markers increased. We initiated antibiotic therapy for the right upper abdominal intracystic infection. The symptoms and inflammatory marker levels improved markedly, and the diameter of the right upper abdominal cyst was reduced to 40 mm. After three months, both cysts were removed by laparoscopic surgery. The preoperative diagnosis was omental cyst (upper right abdominal cyst) and ovarian cyst (pelvic cavity cyst). Upon surgery, the right upper abdominal cyst was found to be present in the omentum, and adhesion with surrounding tissues due to inflammation was observed. The pelvic cyst was an omental cyst with a twisted stem continuing from the omentum. In this case, we differentiated a pedunculated omental cyst from an ovarian cyst. There is room to consider pedunculated omental cysts as a means of differentiating pelvic cystic lesions.