18years female C/o intermittent pain abdomen since 2 months, back pain, nausea since 2 months. H/o white discharge PV since 2 months. USG abdomen(report attached) showing Complex left ovarian cyst ?Hemorrhagic. What is the management??

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Doctor, is she married? pain abdomen. back ache. nausea. white discharge. complex ovarian cyst 3 cms. mostly a hemorrhagic cyst . resolves on it's own. can give tab ceftum 250 mg bd for five days &tab thrize plus bd for five days. give vagi wash for wd. repeat scan after a month. if she is married, then take a vaginal smear for cytology. if it is candidiasis, add fluconozole 150 mg / day for a week. cap pre pro for a week. clingen vaginal suppositories for a week.

It's mentioned to be a haemorrhagic cyst,so it will resolve on its own Put her on anti-inflammatory for 5_7 days Vomitting , nausea is mentioned it can be because of the torsion of the cyst-- rule out with Doppler If twisted ovarian cyst the surgery is warranted. But in Twisted cyst (h'agic) then onset is going to be acute. Rule out h/o worm infestation. Deworming Add calcium Put on a course of Antifungal

I agree with Saigaonkar mam...start with conservative management..by ocp,antibiotics n antispasmodics.rept scan after next periods..if persisting..size decreasing..give ocp...3 months then rept USG..if still present go for lap removal..

This appears to be a simple corpus luteal cyst,if colour Doppler show no vascularisation ,it is more likely to be benign,do CA-125 & CEA to confirm the benign nature,repeat scan on day 3 of menses and many times physiological CL cyst disappear without any treatment ,if still persistent can give a course of OCPills and review again post menses ,If still present only then can opt for Laproscopic removal,do not give vaginal therapy for discharge as she is unmarried and may be a virgin,nausea and pain is not related to cyst as it is long standing and cyst is not big enough to cause twist or pain or internal rupture and haemorrhage ,all the above treatment should be done by a qualified gyn only

CA125 to r/o ovarian cancer if non conclusive then laparoscopic aspiration cytology to arrive at the diagnosis.FAS3 kit to treat pv discharge along with clingen vag suppository for local insertion at night for 7 nights.Ondensetron orally to control nausia

Haemorrhagic cyst may be physiological, antibiotics and anti spasmodic tablets will do,if still patient not getting relieved with pain,then go for laproscopic excision, see that ovary is preserved.

Initially choose conservative treatment - Antibiotics & Anti-spam drugs , symptoms doesn't reduce r reoccurring go for Lap . aspiration & exertion of cyst .

please refer to gynaecologist for further management...

hemorrhagic cyst result from hemorrhage into corpus luteal or functional cyst most hemorrhagic cyst resolve sponteno us with antibiotics within two month if it remain symptomatic go laparoscopic cauterization .try to preserve ovary as pt of less age. avoid the open surgery becoz adhesion formation can be cause of tubal blockage which lead infertility
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Refer to Gynaecologist.

should be careful while aspiration , to avoid spillage ...and could be cystadenocarinoma....leading to peritoneal spread

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