Academic literature on the topic 'Utero-ovarian ligament'

Adnexal torsion is defined as twisting of the ovary and/or tube around usually the utero-ovarian ligament and in case of the ovary the infundibulopelvic ligament. Ovarian torsion is seen in reproductive age group, mainly due to enlongated ovarian ligament. Recurrence is more uncommon. This article presents a case of young 23-year-old women presenting with acute pain abdomen, with scan showing ovarian torsion, an emergency laparoscopy was performed, 1 turn of left infundibulopelvic ligament was noted and detorsion performed along with plication of round and ovarian ligament and utero-ovarian ligament plication. This helps in preventing recurrent ovarian torsion, though there is no standard management to prevent recurrent ovarian torsion, plications to some extent prevents recurrent torsion and thus also preserving fertility of women.

Utero-ovarian ligament fibroids are among the rarest sites for extrauterine leiomyomas. Broad ligament fibroids are relatively common. They can be either asymptomatic or present with chronic pelvic pain and pressure symptoms. They can be confused with an ovarian mass, broad ligament cyst or a pedunculated fibroid. There are high chances of missing it clinically. Ultrasonography, magnetic resonance imaging (MRI) and computed tomography scan are the imaging techniques used to diagnose such conditions, MRI being the most accurate in ruling out other broad ligament masses with suspected ovarian, tubal or isolated broad ligament cyst. Here is a rare case report of a pedunculated extrauterine leiomyoma with its origin in the utero-ovarian ligament.

Introduction. Most cases of ovarian torsion occur in the reproductive age and many are related to ovarian and paraovarian masses. If it occurs without any subtle anatomic etiology or ovarian and paraovarian masses, recurrence of ovarian torsion is more likely. Recurrent left ovarian torsion is much less common than recurrent right ovarian torsion. The authors describe a rare case with their new ovarian fixation technique. Case and Method. A 21-year-old female patient with polycystic ovarian syndrome had a 7th recurrence of left ovarian torsion. Although ovarian fixation was performed in addition to detorsion at the 5th and the 6th laparoscopic surgeries, it had failed. Due to recurrence ovarian torsion after ovarian fixation, the authors performed a different technique:folding the utero-ovarian ligament which folded on itself. The distal part of the utero-ovarian ligament with the ovary was both fixed to the proximal part of the round ligament which was adjacent to the uterus. Conclusion. Although a wide range of oophoropexy methods have been described in the literature, the best method remains a matter for debate. This technique can be performed even when the ovarian tissue is necrotic. Because of this, we think that this technique is useful and effective technique.

Recurrent adnexal torsion is a rare gynecological emergency. We report a case of recurrent ipsilateral adnexal torsion in a woman with polycystic ovaries, previously submitted to a laparoscopic plication of the utero-ovarian ligament. Due to the recurrence after the plication of the utero-ovarian ligament, the authors performed a laparoscopic oophoropexy to the round ligament, which is an underreported procedure. The patient was asymptomatic for 1 year, after which she had a new recurrence and needed a unilateral laparoscopic adnexectomy. Since then, she regained the quality of life without any gynecological symptoms.Oophoropexy to the round ligament may be considered when other techniques fail or, perhaps, as a first option in selected cases of adnexal torsion, as it may allow the prevention of recurrence without increasing morbidity while preserving the adnexa.

Background: Arterial rupture associated with pregnancy is an important cause of fatal hemorrhage in pregnant mares, regardless breeds and age. Such hemorrhagic events lead to blood loss into the abdomen, broad ligament and uterus and the broad ligament hematoma occurs as a consequence of arterial rupture. Although the rupture of the uterine artery is commonly caused by hemorrhage, there are few studies regarding this condition. Therefore, the aim of this study was to describe a case of rupture of the utero-ovarian artery, with broad ligament hematoma and intramural uterine hematoma in a Thoroughbred mare, emphasizing the predisposing factors and the diagnosis process.Case: A 13-year-old Thoroughbred mare, with nine parturition, was attended with abdominal pain after foaling. The mare had an eutocic delivery, however the foal was a big one to the race, with high of 1,02 m and weight of 68 kg. The animal arrived at the Veterinary Clinical Hospital 48 h after delivery, with abdominal pain, pale mucous membranes, heart rate slightly increased. The trans-rectal palpation revealed the presence of a solid mass in the left horn region, and it was painful to the touch. The ultrasonography evaluation of the mass showed a heterogeneous texture with a hypoechoic central area, which reinforced the clinical suspicion of a hematoma in the broad ligament and a uterine intramural hematoma. The animal did not respond to analgesic therapy, which resulted in shock and consequently death. Necropsy revealed free blood in the abdominal cavity and the uterine wall with swollen hematoma extended to the left broad ligament. It also showed the presence of a hematoma along the uterine wall, from the uterine body region to the ovarian insertion. Histological evaluation did not show significant changes in the arterial wall, and it revealed the formation of intramural hematoma thorough all extension of the left uterine horn, confirming the suspicion of rupture in the utero-ovarian artery and hematoma on the broad ligament and uterine intramural hematoma in the left horn.Discussion: Rupture of uterine arteries can occur at any age, although it is often observe in old mares, possibly because of the vascular degenerative features observed in these animals. In addition, multiparous mares are more prone to it because multiple births can favour damages in vascular system. The clinical assessment showed characteristics compatible with postpartum hemorrhage. A thorough trans-rectal evaluation revealed a mass in the left horn. The ultrasonography evaluation from the mass showed echogenic characteristics consistent with those described for broad ligament hematoma and uterineintramural hematoma in the left horn. The clinical suspicion, rupture of the uterine artery, with formation of a hematoma in the broad ligament and uterine intramural hematoma, was based upon the history, clinical signs and laboratory tests, especially the characteristics revealed by the ultrasound from the mass in left horn. Necropsy showed the rupture of the utero-ovarian artery. Lesions are usually observed on the right uterine artery due to the displacement of the uterus to the left abdominal wall by the cecum, which results in an increased tension on the right broad ligament. However, in this case the rupture was associated to the gravid horn. The rupture of the utero-ovarian artery is a major cause of hemorrhage in the postpartum and this can form a hematoma in the broad ligament and uterine intramural hematoma. In conclusion, the mare from this study showed as the predisposing factors the age and the number of parturition. Clinical sings are very similar to others abdominal pain conditions, being the exams essential to diagnosis, especially ultrasonography. Rupture of the utero-ovarian artery is an emergency with unfavorable prognosis.Keywords: artery, utero-ovarian, mare, hemorrhage.

Introduction Adnexal torsion is 5th most common gynaecological emergency occurring in about 2 - 15% of reproductive age group women, wherein both ovary and fallopian tube twist along the vascular pedicle which causes obstruction to venous outflow and arterial inflow. Dr Sachins criteria for adnexal torsion management: 1. If adnexal torsion + ovarian cyst = / > 5cm do ovarian cystectomy. 2. Measure utero-ovarian ligament length if it is = / > 5cm do ligament plication. 3. In cases of torsion in pre-menarcheal girls & case of recurrent torsion do utero-ovarian ligament plication using hot dog in bun technique. 4. If Pcod is the cause of torsion then do detorsion + Pcod drilling + utero-ovarian ligament plication if it is >5cm + use medical ovarian suppression for 6 month. Aim of study To find out age incidence for adnexal torsion cases and to compare it with other similar studies To analyse & compare different management modalities being used for adnexal torsion management. To analyse the side specific occurrence of adnexal torsion and to compare it with other studies. To find out & compare the incidence of Salpingo-Oophorectomy among adnexal torsion cases. To find out the correlation of size of ovarian cyst and adnexal torsion. Materials and method 44 patients who underwent laparoscopy for adnexal torsion & managed following “Dr Sachin's criteria for adnexal torsion management” were studied & followed up prospectively for a period of 7 years from 2017-2024. Variables studied were age group of patients, parity, marital status, previous surgery, correlation of ovarian cyst size and torsion, incidence of torsion in pre-menace girls and management options. Conclusion At present there are no definite guidelines for adnexal torsion management and so different available surgical options are being used by different operating surgeons worldwide &.there is no standardisation of management protocols at present so this criterion is an attempt to standardise the the management protocol & bring in the uniformity in management of adnexal torsion cases so these patients can be benefitted worldwide.