severe ovarian edema
Introduction
Introduction to severe edema of the ovary Severe ovarian edema is the retention of edema fluid in the interstitium of the ovary, separation of normal follicles and interstitial tissue, resulting in severe ovarian enlargement, so called ovarian severe edema. The cause of severe ovarian edema may be due to ovarian mesangial torsion, affecting ovarian lymphatic and venous return, water deposition in the ovary, a small number of ovarian cortical stromal cells proliferating, resulting in increased ovarian volume and weight, Young, Scully believes Multifocal fibrosis in the ovary is one of the causes of severe edema. basic knowledge The proportion of women: the incidence rate of women over 45 years old is about 0.004% - 0.007% Susceptible people: women Mode of infection: non-infectious Complications: McGregor syndrome
Cause
Causes of severe edema of the ovary
(1) Causes of the disease
The cause of severe ovarian edema may be due to ovarian mesangial torsion, affecting ovarian lymphatic and venous return, water deposition in the ovary, a small number of ovarian cortical stromal cells proliferating, resulting in increased ovarian volume and weight, Young, Scully believes Multifocal fibrosis in the ovary is one of the causes of severe edema.
(two) pathogenesis
1. Most of the macroscopic morphology is unilateral ovarian involvement. In the literature, only 6 of the 51 cases were bilateral. The affected ovary was 5.5-35 cm in diameter, with an average of 11.5 cm and a weight of up to 2400 g. The ovary was soft and the surface was smooth and pale. Or pink, shiny, opaque, when reversed, the ovary may be dark purple due to stroke, the cut surface is moist, often with a yellowish liquid spilling out, and a thin vesicle is visible in the superficial cortex.
2. Histomorphology The ovarian tunica albugis is intact, the superficial fibrosis is proliferated, and the large edema tissue under the superficial layer surrounds the residual normal ovarian structure, including follicles and occasional corpus luteum and white body, and the interstitial area near the edema area, sometimes visible Flavonoid cells or focal fibrosis, lymphatic vessels in the medulla, high blood vessels.
Prevention
Ovarian severe edema prevention
Early detection, early treatment, active prevention and treatment of complications, and good follow-up.
Complication
Severe edema complications Complications McGregor syndrome
Fukuda has reported severe edema of the ovary with chest and ascites and other manifestations of Meg's syndrome.
Symptom
Symptoms of severe edema of the ovary Common symptoms Acute abdominal pain Sports amenorrhea Abdominal pain Amenorrhea Lower abdominal mass Ovary deficiency or hypoplasia Menstrual cycle changes Male uterus attachment Tumor edema
1, ovarian unilateral increase, can be attached to the attachment lumps.
2, more abdominal pain or pelvic pain, or acute abdominal pain. Often accompanied by bloating.
3. Irregular menstruation or amenorrhea.
4. Half of the patients had partial or complete ovarian torsion.
5, a small number of patients with masculine symptoms, serum testosterone levels increased.
Examine
Examination of severe edema of the ovary
1. Pathological examination of ovarian tissue.
(1) General examination
Mostly unilateral, the average diameter of the affected ovaries is 11.5cm.
Soft, smooth surface, pale or pink, shiny, opaque. The twister is dark purple.
The cut surface is moist and overflows with a pale yellow liquid.
Sparse vesicles appear in the superficial cortex.
(2) Organizational form
The tunica albuginea is intact, the superficial cortex has fibrosis, and there is residual normal ovarian structure below.
Medulla area: The blood vessels and lymphatic vessels are highly dilated.
Interstitial near the edema area: or visible focal luteinized cells or focal fibrosis.
2, laparoscopy.
3. Detection of hormone levels.
4, B-ultrasound.
Diagnosis
Diagnosis and differential diagnosis of severe edema of ovary
diagnosis
According to clinical manifestations, symptoms and examinations are not difficult to make a diagnosis.
Differential diagnosis
1. Ovarian fibroma edema is a true tumor, lacking ovarian follicles, white body and other structures, can not distinguish the cortex, medulla, so it is different from this disease.
2. Polycystic ovary disease Polycystic ovary is bilateral, ovarian white film is significantly thickened, multiple cystic follicles under the cortex, clinical infertility, hairy, obese, and this disease is more common on one side, no ovarian white The membrane is thickened, the collagen fibers are proliferated, the ovary is smooth and enlarged, and the quality is soft.
3. Ovarian sclerosing stromal tumor is rich in vascular, interstitial cell hypertrophy, edema area is dense and hardened area, lesions affect all ovaries, lack of normal ovarian structure, so it is different from this disease.
