Hypovolemic shock due to giant ovarian tumor rupture after minor trauma: A case report

Rupture of gynecologic tumors secondary to trauma rarely occurs. Rupture can lead to acute abdominal pain due to hemorrhage from the ruptured area and organs; rupture can also lead to peritonitis, depending on the size of the tumor. We describe the case of giant epithelial ovarian tumor rupture exhibiting due to minor trauma and the development of hypovolemic shock. A 69-year-old female patient was admitted to the emergency room with complaints of acute abdominal pain and subsequent clouding of consciousness after falling down while walking. Emergency abdominal computed tomography scan revealed widespread hemorrhagic free fluid in the abdominal cavity and a mass measuring 27.5 cm × 21 cm × 15 cm, extending from the right quadrant of the abdomen to the left. The patient underwent an emergency operation due to hypovolemic shock. During surgery, a totally ruptured mass lesion arising from the right ovary was seen; the mass contained cystic components and measured approximately 30 cm × 20 cm × 15 cm. Hemostasis was achieved in the bleeding areas, and the right ovarian mass was totally resected. The patient was discharged as cured on the 6th post-operative day. Gynecologic tumor rupture due to trauma is a rare event. However, it is a clinical condition that should be kept in mind regardless of the type of trauma. This is especially true in patients who experienced trauma and were radiologically found to have intra-abdominal hemorrhage with normal-appearing solid organs, such as liver and spleen, that frequently cause bleeding.

Minör travma sonrasý dev over tümörü rüptürüne baðlý geliþen hipovolemik þok: Olgu Sunumu

Travmaya baðlý jinekolojik tümör rüptürleri oldukça nadir görülür. Rüptür, tümör çapýna ve kanamaya baðlý olarak rüptüre olduðu alan ya da organda akut abdominal aðrýya yol açabildiði gibi, peritonite de sebep olabilmektedir. Bu çalýþmamýzda, minör travma sonrasý geliþen rüptüre baðlý hipovolemik þok tablosuna neden olan dev epitelyal tip over tümör rüptürü olgusunu sunacaðýz. Altmýþ dokuz yaþýnda kadýn hasta yürürken yere düþme sonrasý geliþen karýn aðrýsý ve bilinç bulanýklýðý þikayetleriyle hastanemiz acil servisine baþvurdu. Abdominal tomografide karýn içi yaygýn hemorajik sývý ve 27.5x21x15 cm çapýnda karýn sað alt kadrandan sol kadrana doðru uzanan kitle lezyonu tespit edildi. Hasta hipovolemik þok tablosunda acil ameliyat edildi. Ameliyatta sað over kaynaklý, ortasýndan tamamen rüptüre olmuþ, kistik komonentler içeren ve yaklaþýk 30x20x15 cm çapýnda kitle lezyonu saptandý. Kanama alanlarýnda hemostaz saðlanarak kitle total olarak çýkarýldý. Hasta ameliyat sonrasý altýncý gün þifa ile taburcu edildi. Travmaya baðlý jinekolojik tümör rüptürleri nadir görülür. Ancak travmanýn tipine baðlý olmaksýzýn mutlaka akýlda tutulmasý gereken bir durumdur. Bu durum özellikle travma sonrasý radyolojik olarak karýniçi kanamanýn saptandýðý ancak sýklýkla yaralanan karaciðer ve dalak gibi organlarýn radyolojik olarak normal olduðu durumlarda önemlidir.