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    Self Amputated Ovarian Cyst: An Unexpected Laparoscopic Finding

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    Today laparoscopy is necessary in the diagnostic and therapeutic management of abdominal masses also in neonatal period. We report the case of a 28 days old girl admitted in our department with a prenatal diagnosis of abdominal mass. The ultrasound and CT scan revealed a 4 cm cyst in the right superior abdominal region. Instead the MRI revealed the mass localized in the right iliac region. A diagnostic laparoscopy with an open transumbilical approach was performed, that revealed an intra-abdominal 5 cm cystic formation with a thin vascular bundle. A minimal laparotomy was performed and the cyst removed. The histological examination indicated a self amputated ovarian cyst. Laparoscopy is proved to be a significant contribution in the diagnosis of abdominal masses because it allows a correct diagnosis and to plan the best management

    Role of laparoscopy in the management of isolated falloppian tube torsion in adolescents

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    Background/Purpose Isolated Fallopian tube torsion (IFTT) is a rare cause of acute abdominal pain in female. The preoperative diagnosis is difficult because of a lack of specific clinical and radiological signs. Surgery is often performed when is no longer possible to preserve the integrity of the tube. We report our experience in the laparoscopic management of four teenagers with IFTT. Methods Four patients (aged 12 to 15 years) came to our observation for worsening abdominal pain, nausea and vomit. On admission all girls had blood tests, ultrasound and Magnetic Resonance. Laparoscopy was performed in all cases for the diagnosis. All girls had US and clinic follow up. Results Laparoscopic exploration allowed the diagnosis of IFTT with necrosis of the same in all cases. In two girls a laparoscopic salpingectomy was performed. In the other two cases an open salpingectomy was necessary because of pelvic adhesions. Histology showed a hemorrhagic infarction of the Fallopian tubes. At follow up all patients were asymptomatic with normal ovaries. Conclusions In the differential diagnosis of acute abdominal pain in children or female adolescents the possibility of IFTT should always be considered, since an early diagnosis can lead to a conservative treatment. Laparoscopy allows to perform a definitive diagnosis and treatment
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