Lethal outcome after percutaneous aspiration of a presumed ovarian cyst in a neonate.
Semin Pediatr Surg
; 18(2): 119-21, 2009 May.
Article
en En
| MEDLINE
| ID: mdl-19349004
ABSTRACT
Most surgeons agree that complex neonatal ovarian cysts, regardless of size, warrant operative intervention. Management of simple cysts >4 cm is still controversial, although many favor intervention because of the increased risk of torsion. Whereas laparoscopic cyst resection is favored by some, others prefer less invasive percutaneous needle aspiration. We present a newborn infant who was admitted with sepsis and respiratory failure after home delivery. Ultrasound done on day 8 to check for umbilical venous line placement incidentally showed a simple cyst measuring 3.6 x 5.9 x 6.9 cm that was presumed to be of ovarian origin. Percutaneous needle aspiration was atraumatic and revealed serous fluid, with a high estradiol level. Four days later, surgery was indicated for clinical deterioration with suspected hemorrhage into the cyst. We found a midgut volvulus with extensive necrosis secondary to a jejunal duplication cyst. Ovaries were normal and there was no evidence of malrotation. Postoperatively, after discussion with the parents, support was withdrawn and the child died. We should not rely solely on ultrasonographic features and fluid characteristics to diagnose a large neonatal abdominal cyst, but rather confirm the diagnosis with laparoscopy.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Quistes Ováricos
/
Drenaje
/
Quistes
/
Vólvulo Intestinal
/
Biopsia con Aguja Fina
/
Enfermedades del Yeyuno
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
Límite:
Female
/
Humans
/
Newborn
Idioma:
En
Revista:
Semin Pediatr Surg
Asunto de la revista:
PEDIATRIA
Año:
2009
Tipo del documento:
Article
País de afiliación:
Canadá