Laparoscopic surgery for intestinal obstruction due to compression of ovarian cystic teratoma

Abstract

Introduction: Ovarian teratomas are benign tumors. While bowel obstruction is a common complication of advanced ovarian cancer, it is rarely described in cystic lesions such as ovarian teratomas. To our knowledge, the case we describe herein is the first reported case of large bowel obstruction due to a large benign ovarian teratoma treated using laparoscopic surgery.

Case: A 19-year-old woman with complaints of acute abdominal pain was admitted to our hospital. Computed tomography and magnetic resonance imaging revealed a 12-cm left ovarian teratoma that caused compression of the sigmoid colon with consecutive dilation of the ascending colon and small bowel. We diagnosed the patient as having an intestinal obstruction. After an unsuccessful conservative ileus treatment including a starvation cure and intravenous administration of fluids for 2 days, we performed a laparoscopy and found a large cystic tumor originating from the left adnexa. No adhesions were observed in the pelvic space. After removal of the tumor via left cystectomy, histological findings confirmed a benign teratoma. The patient's hospital stay was uneventful, and the bowel obstruction symptoms resolved immediately.

Conclusion: The clinical course of our patient provides the following important insights: Ovarian teratomas can present intestinal obstruction. With accurate preoperative diagnosis and careful management, intestinal obstruction due to ovarian teratoma can be treated using laparoscopy.