Elsevier

Journal of Minimally Invasive Gynecology

Volume 24, Issue 6, September–October 2017, Pages 1040-1045
Journal of Minimally Invasive Gynecology

Case Report
Laparoscopic Intervention in Acute Crohn's Disease Involving an Ovary

https://doi.org/10.1016/j.jmig.2017.04.028Get rights and content

Abstract

Crohn's disease (CD) is a chronic inflammatory disorder that may involve any part of the gastrointestinal tract. Acute manifestations in female internal reproductive organs are rare and have been described in only a few cases. A 27-year-old nulligravida woman diagnosed with CD presented with pelvic pain, fever, and a palpable mass (confirmed by ultrasound) in the right lower quadrant of the abdomen. She underwent diagnostic laparoscopy because of worsening symptoms suggestive of a tubo-ovarian abscess. The right adnexa were excised after adhesiolysis. Pathologic examination revealed an ovarian granuloma consistent with CD. This case shows that a laparoscopic approach is possible for active CD, with all the benefits of a minimally invasive approach. Although the involved ovary was removed, similar to previous reports using laparotomy, conservative therapy should be considered if preoperative diagnosis can be made. Improvements in preoperative diagnosis and development of management guidelines is critical for ovarian preservation and conservative treatment options.

Section snippets

Case Report

Institutional Review Board approval was obtained for this case. In October 2015 a 27-year-old nulligravida woman with underlying CD and an ovarian mass was transferred to the department of minimally invasive gynecology from the gastroenterology ward of Jagiellonian University Medical College, Krakow, Poland, after hospitalization for 3 days because of pelvic pain and fever.

Discussion

To our knowledge, this is the first reported case of ovarian CD managed by laparoscopy with all the associated benefits. In light of the previous cases of CD and ovarian granuloma that have been managed by laparotomy (Table 1) 2, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, this report raises the question regarding the possibility and safety of conservative management, refraining from gynecologic interventions completely, and the best therapeutic option to preserve fertility.

The

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    • A case-report on diverticulitis misdiagnosed as tubo-ovarian abscess

      2021, Annals of Medicine and Surgery
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      The removal of abscesses wall included salpingo-oophorectomy, hysterectomy and colectomy. Overall, 7 cases of TOA complicated with diverticulitis (1 appendix diverticulitis and 2 sigmoid) were seen [12–21]. Usually, pelvic abscess in women is attributed to genital organ and other causes are ignored.

    The authors declare that they have no conflict of interest.

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