Strangulated ileus due to an ovarian cyst in a neonate

Abstract

The patient was a 1-day-old female neonate. A cystic lesion had been found underneath the fetal stomach, and magnetic resonance imaging revealed a 50-mm cyst in the left ovary. The infant was delivered spontaneously at 39 weeks 3 days. Postnatal abdominal ultrasonography showed debris in the cyst. The neonate vomited a large amount of bile 32 h after birth, and emergency surgery was performed. The cystic lesion, diagnosed as a necrotic ovarian cyst, was removed from the abdominal cavity. It was connected to a long cord that appeared to be the fallopian tube. The cord had caused a strangulated ileus due to compression of the mesentery. About 20 cm of the necrotic intestinal tract was resected along with the necrotic ovarian cyst. A cyst containing debris is considered complex, and complex cysts are associated with ovarian torsion. There is no consensus on a treatment strategy for addressing this situation in a neonate. Recently, there has been a trend toward observation without surgery, with the goal of preserving the ovary. However, we recommend early laparoscopic examination and surgical intervention for a complex cyst discovered around the time of birth.

Keywords

• Strangulated ileus
• Ovarian cyst
• Neonate