Ovarian apoplexy is one of the most dangerous conditions in gynecology, which can lead to extremely dangerous consequences. Ovarian apoplexy is a rupture of ovarian tissue, which occurs as a result of exposure to a large number of factors. In some cases, the cause of rupture of the ovary can be excessive exercise, inflammatory disease or trauma to the abdomen, sometimes apoplexy can occur on the background of stress or in a state of absolute rest. What to do if doctors diagnose you with this disease? About methods of treatment of ovarian apoplexy knows everything estet-portal.com.
Conservative and surgical treatment of ovarian apoplexy
Rupture of ovarian tissue is one of those pathological conditions in gynecology that cause the appearance of a clinical picture of an acute abdomen, which is why the treatment of ovarian apoplexy should begin as early as possible. In the hemorrhagic form of ovarian apoplexy, bleeding occurs from the ovarian vessels into the abdominal cavity, and in case of blood loss of more than 50% of the circulating blood volume, the patient experiences irreversible decompensated hemorrhagic shock, which causes death. It is necessary to seek qualified medical help when the first symptoms of ovarian apoplexy appear.
Treatment of ovarian apoplexy:
- conservative methods of treatment of ovarian apoplexy;
- laparoscopic method of treatment of ovarian apoplexy;
- laparotomy treatment of ovarian apoplexy.
Conservative methods of treatment of ovarian apoplexy
The choice of treatment for ovarian apoplexy depends on which leading syndrome prevails in the clinical picture of the disease. In the painful form of ovarian apoplexy or mild hemorrhagic form, with minor intra-abdominal bleeding (blood loss up to 150 ml.) Without signs of its increase, it is possible to prescribe a conservative treatment for ovarian apoplexy, which includes:
- bed rest and complete rest;
- ice on the lower abdomen;
- hemostatic drugs;
- antispasmodics;
- vitamin therapy;
- physiotherapy procedures: electrophoresis, microwave therapy.
Conservative treatment of ovarian apoplexy must be carried out in a hospital under round-the-clock monitoring of the patient's condition. In the event of new symptoms of the disease or the ineffectiveness of conservative therapy, the patient is indicated for surgical intervention.
Laparoscopic treatment of ovarian apoplexy
The choice of the method of surgical treatment depends on the course of the pathology in each individual case. Indications for laparoscopic treatment of ovarian apoplexy:
- presence of more than 150 ml. blood in the abdominal cavity according to ultrasound data, subject to the normal condition of the patient and stable hemodynamic parameters;
- ineffectiveness of conservative treatment within 1-3 days;
- signs of ongoing intra-abdominal bleeding, as confirmed by ultrasound;
- need to differentiate gynecological pathology from acute surgical pathology.
Laparotomy treatment of ovarian apoplexy
Laparotomy treatment of ovarian apoplexy is indicated in the following cases:
- the patient's serious condition due to profuse intra-abdominal bleeding with serious hemodynamic disturbances;
- the impossibility of laparoscopy due to the presence of adhesions in the pelvis or increased bleeding from damaged ovarian vessels.
Laparotomy is performed by infero-medial approach or through a Pfannenstiel incision above the pubis. The volume of surgical intervention should be as sparing as possible: coagulation of the rupture site, opening or puncture of the cyst and removal of its contents, resection of the ovary. If there is a large area of damage to the ovary or if it is not possible to save it, the damaged ovary is removed.
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