Dirk Schaper, P. Göbel (Kinderchirurgie St. Barbara-Krankenhaus Halle/S.)  

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6 Weeks  

Female  

Pelvis-Ovars  

other  

Cesarean section due to H-gestosis after 32 gestational weeks. Postnatally, slight dyspnea and tachypnea, although good adaptation. Phototherapy for hyperbilirubinemia.

In the course of time, continuous crying. Upon abdominal palpation, increased irritability. No vomiting.

Age at presentation: 6 weeks.  

N/A  

<- view Ultrasound 1

Ultrasound 1: Lower left abdomen, transverse: Close to the abdominal wall, an echo-free structure is nooted with an irregular shape and without definitive capsule. Within this structure, there is another echo-free spherical structure.




<- view Ultrasound 2

Ultrasound 2: Lower left abdomen, sagittal: A structure is identified cranial to the bladder. A connection to the bladder cannot be excluded with certainty.




<- view Ultrasound 3

Ultrasound 3: Lower left abdomen, transverse: Shown is the structure with its dimensions.




<- view OP-Situs 1

OP-Situs 1: Laparoscopy of thel ower abdomen with the pathology being presented.




<- view OP-Situs 2

OP-Situs 2: Surgery, laparoscopy , aspiration

 

Surgery / Histo  

Mesenterial cyst, ureterocele, omental cyst  

Following diagnostic imaging, laparoscopy was performed for final diagnosis. The suspected ovarian cyst was confirmed; however there were two cysts which were very close to one another. Therefore the findings of a cyst within a cyst was made.

The cysts were aspirated and consequently fenestrated. Furthermore, tissue was sent for histological examination.  

In case of a neonatal ovarian cyst, usually an awaiting position is acceptable if there are no symptoms and the finding does not cross any threshold values. In our case, the child was symptomatic and the findings were ambiguous. Therefore we decided for a laparoscopic therapy.  

N/A  

1. Medline:
Vogtlander MF, Rijntjes-Jacobs EG, van den Hoonaard TL, Versteegh FG
Neonatal ovarian cysts
Acta Paediatr. 2003 Apr; 92(4): 498-501

2. Medline:
Khong PL, Cheung SC, Leong LL, Ooi CG.
Ultrasonography of intra-abdominal cystic lesions in the newborn
Clin Radiol. 2003 Jun; 58(6): 449-54.

3. Medline:
Mittermayer C, Blaicher W, Grassauer D, Horcher E, Deutinger J, Bernaschek G, Ulm B
Fetal ovarian cysts: development and neonatal outcome.
Ultraschall Med. 2003 Feb; 24(1): 21-6.  

Ovarian cyst, ovarian, cyst, neonate, newborn, septated cyst, septated ovarian cysts,cyst within a cyst, child, childhood, pediatric radiology  

Dirk Schaper, P Göbel. Neonatal "Chambered" Ovarian Cyst - Cyst within a Cyst. PedRad [serial online] vol 4, no. 1.
URL: www.PedRad.info/?search=20040120163117