The infarction of ovarian cyst is a medical condition in which the cysts present in the ovaries become non-viable. This occurs due to the lack in supply of oxygen as well as the blood. Such an ovary is called infarcted ovary due to the presence of the necrotic tissue within the ovary. Infarcted ovarian cyst is considered as a gynecological emergency which requires immediate attention as with time the risk of complications increase, finally leading to the loss of ovary.
Infarcted Ovarian Cyst: An overview
Ovaries are the prime organ of the reproductive system which is located in the lower abdomen. These primarily contribute to the production of egg cells for the process of fertilization as well as the synthesis of female hormones like estrogen and progesterone.
Sometimes, when the levels of androgens are high in the female body, cysts develop within the ovaries. The cysts are minute sacs that are filled with fluid. In case of infarcted ovarian cyst, these cysts suffer from obstructed blood supply and limited supply of oxygen, ultimately leading to the death of the cyst or infarction. This usually happens when the uterus undergoes ovarian torsion.
Ovarian torsion is condition in which the ligaments that support the ovaries rotate in either complete or partial manner. This happens due to twisting of the fallopian tubes which further results in limited supply of oxygen as well as blood. It causes acute pain which is localized in the lower abdomen and in extreme cases it may also result in loss of ovary. Ovarian torsion can be categorized into two types namely adnexal torsion and isolated torsion. In case of adnexal torsion, the ovary and the fallopian tube both get twisted whereas in case of isolated torsion, the fallopian tubes get twisted along the centre of the tube and injure the ligaments that support the ovaries.
Symptoms of Infarcted Ovarian Cyst
The common signs and symptoms that mark the onset of this condition are:-
- Abrupt occurrence of severe pain in the lower part of the abdominal and pelvic region, usually localized on one side of the body.
- The intensity of the pain varies greatly from individual to individual which may range from constant cramping to sharp and stabbing kind of pain in lower abdomen.
- The pain may radiate from the lower abdomen towards the lower back region and the thighs.
- Frequent occurrence of vomiting.
- Nausea and dizziness
- Presence of mild fever
- Presence of diarrhea or constipation.
- The infarction may cause the uterus to shift to the side of the body.
Prognosis of Infarcted Ovarian Cyst
The outlook and prognosis for infarcted ovarian cyst is excellent when the patient receives prompt diagnosis and appropriate treatment. The loss of ovary usually occurs in the cases which go unnoticed or undiagnosed.
Causes of Infarcted Ovarian Cyst
The primary causes that contribute to the infarction of the ovarian cysts are ovarian torsions. The torsions can occur due to multiple reasons which are:
- Congenital presence of the torsion.
- Developmental abnormalities in the ovaries.
- Presence of diseases that affect the ovaries.
- Occurrence of spasms in the ligaments that support the ovaries.
- Absence of the ligaments supporting the ovaries.
- Blood vessels connected to the ovaries may undergo changes in their structure.
- Fallopian tubes may be longer than the usual size.
- Presence of tumors, cysts or fibromas in the ovaries.
Pathophysiology of Infarcted Ovarian Cyst
The infarction usually results due to the complete rotation of the fallopian tubes as well as the ovaries. The infarction leaves behind an enlarged mass of non-viable cysts on the ovaries. In most cases, infarcted ovarian cyst is known to affect the right side of the female body. This condition is age independent but in case of young girls, who suffer from infarction before they hit the puberty usually have normal ovaries with not many complications.
Diagnosis of Infarcted Ovarian Cyst
The preliminary diagnosis involves the physical examination and checking for the signs and symptoms that signifies the condition of infarcted ovarian cyst. Also, the doctor may check for the presence of pregnancy. The other diagnostic techniques that are conducted to identify and confirm the ovarian torsion and infarction are:
- Ultrasound to Identify Infarcted Ovarian Cyst: This technique utilizes the sound waves generated by a transducer, which provides the clear picture of ovaries on reflection. It is used to check the presence of enlarged ovary, edema, lesion in the ovary, infection ailing the ovary and the cysts and hemorrhage.
- Doppler Test to Diagnose Infarcted Ovarian Cyst: This is another technique which also uses sound waves for identifying the condition of infarcted ovarian cyst. This technique focuses on the analysis of blood flow through the blood vessels, which is then utilized to check the blood flow within the arteries and veins of the ligaments that support the ovaries.
- CT Scan to Identify Infarcted Ovarian Cyst: This is one of the many imaging techniques which provide the cross-sectional image of the ovaries with the help of computers. The test identifies the enlarged ovary, hemorrhagic necrosis, stranding of the fat surrounding the ovaries, presence of free fluid or edema.
- Pelvic MRI for Diagnosing Infarcted Ovarian Cyst: MRI is an imaging technique that uses the combination of magnetic radiations and computer technology to generate the three dimensional images of the ovary to check for infarction due to hemorrhage. It is a diagnostic measure which is taken up during emergency situations.
Treatment for Infarcted Ovarian Cyst
The treatment for the infarction of ovarian cysts is surgery. When a patient with such condition is encountered then primary treatments that are prescribed are pain relieving medications like NSAIDS. These also check the occurrence of nausea and dizziness. The surgical treatment that follows depends on the severity of the condition of infarcted ovarian cyst. For less severe cases of infarcted ovarian cyst, laparoscopic surgery is conducted whereas in severe cases open surgery is done to untwist the ovary. This restores the optimal supply of blood and oxygen to the ovary which in turn ensures the viability of the ovarian cysts. For the cases, in which the tissue necrosis has occurred already, the non-viable mass present on the enlarged ovary are removed surgically.
Infarcted ovarian cyst is a condition that occurs due to ovarian torsion. The ovarian torsion results in twisting of the fallopian tube which further obstructs the blood supply as well as the oxygen to the ovary and the underlying cysts. This then results in infarction of the cysts. These masses of dead cysts form an enlarged ovary. The condition is marked by the presence of severe pain in lower abdomen, nausea and dizziness in the individuals. When left unnoticed, unattended or undiagnosed, infarcted ovarian cyst may lead to loss of ovary. Hence, if any related symptoms are observed then a prompt diagnosis and optimal treatment should be provided.