Autoamputation

Abstract: Autoamputation of the ovary is a rare occurrence of uncertain aetiology with only a few cases reported in literature. It usually develops following ovarian torsion or torsion of a dermoid cyst with subsequent necrosis of the pedicle and autoamputation. We present the case of a 42 year-old woman was admitted for a laparoscopic removal of a right ovarian cyst. The ultrasound showed a right ovarian cystic mass suggestive of a cystadenoma, and another heterogeneous small echogenic cyst of the left ovary. During laparoscopy, excessive bleeding from the ovarian cortex complicated the cyst stripping and, considering the age of the patient and the emerging technical difficulty of the procedure, a total adnexectomy for the right ovary was performed. While exploring the small cyst on the left ovary, a dermoid cyst was found in the Douglas pouch. This finding could be interpreted as an autoamputation of the adnexa due to an asymptomatic torsion of a previous ovarian cyst arising from the left ovary. Medical errors could occur due to lack of knowledge, expertise, as well as lack of training and surgical skills, but also due to an unfortunate association of very rare confounding factors. Even in the hands of experts, following the basic rules of surgery remains a milestone in teaching and preventing surgical complications.

Abstract: We present a case of adult intussusception with autoamputation and preservation of bowel continuity. Our patient, a 65-year-old man, passed a 65-cm segment of large bowel per anus with spontaneous recovery and with a two-month follow-up free of symptoms secondary to the intussusception. Mesenteric ischemia secondary to angiography with distal embolization two weeks prior to the event may have been a precipitating factor in this unusual form of intussusception

Abstract: Introduction: Case reports of parasitic teratomas exist; however, most viable ovarian dermoids reimplant into the omentum. It is rare to report a viable ovary containing a dermoid that has undergone autoamputation and reimplantation in the posterior cul-de-sac. Case Description: We report the case of a 48-year-old woman with a history of lower abdominal pain that was relieved with pain control and recurred 1 year later, prompting a diagnostic laparoscopy. Laparoscopy confirmed an ovarian dermoid cyst in the posterior cul-de-sac. Intraoperatively, the ovary containing the dermoid appeared viable; this was confirmed by histopathology. Discussion: The mass found on laparoscopy can best be explained by torsion, autoamputation, and reimplantation of the ovary containing the mature cystic teratoma into the posterior cul-de-sac.

Abstract: Autoamputation of the ovary may be a result of longstanding infarction resulting from torsion of the ovarian pedicle. This entity may be confused with an ectopic or supernumerary ovary. A proper detailed history taking is important to provide clues for diagnosis. We report a case of a young female patient diagnosed with autoamputation of unilateral ovary on laparoscopy, with histopathology confirmation of ovary with dermoid cyst.