PMC5316793_01
(a) Axial image showed a left ovarian cyst measuring 6.0 cm x 4.5 cm. (b) Computed tomography of the abdomen. Median sagittal section showed an increased fat-density mass
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F1
An abdominal computed tomography (CT) was performed and showed a left ovarian cyst measuring 6.0 cm x 4.5 cm with no other remarkable findings [Figure 1a]. By reanalyzing the preoperative CT, a segmental fat mass with an increased density was noted in the left lower quadrant which was consistent with the intraoperative findings [Figure 1b].
Laparoscopy. (a) Adhesion between small intestine and abdominal wall. (b) A dark purple mass on the left side in the lower part of the omentum and bloody ascites in the left abdomen. (c) A huge ovarian cyst
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F2
During the procedure, we found a segment of congested necrotic omentum adhering to the abdominal wall with a segment of small intestine [Figure 2a], bloody ascites (200 mL) accumulated in the abdominal cavity [Figure 2b], and an ovarian cyst measuring 6.0 cm x 4.5 cm in pelvic cavity [Figure 2c].
Histological examination of the resected nonviable omentum revealed hemorrhagic infiltrations, thrombosis of the tissue, acute inflammatory cellular infiltrate, and fibrinoid necrosis
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F3
Final pathological examination revealed hemorrhagic infiltrations, thrombosis of the tissue, acute inflammatory cellular infiltrate, and fibrinoid necrosis, and POI was diagnosed [Figure 3].