Severe ovarian edema

　　The cause of severe ovarian edema may be due to ovarian mesenteric torsion, affecting ovarian lymph and venous return, leading to water retention in the ovary. A few cases are due to hyperplasia of stromal cells in the ovarian cortex, which increases the volume and weight of the ovary and leads to torsion. Some experts believe that multifocal fibrosis in the ovary is one of the causes of severe edema.
　　Most cases involve unilateral ovarian involvement, with the involved ovary having a diameter of 5.5 to 35 cm, averaging 11.5 cm, and the maximum weight reaching 2400g. The ovaries are soft, the surface is smooth, pale or pink, with a glossy appearance and opacity. When torsion occurs, the ovary may become dark purple due to infarction. The cut surface is moist, and there is often a faint yellow fluid exuding. Sparse cysts can be seen in the superficial cortex. The ovarian white membrane is intact, the superficial cortex has fibrous hyperplasia, and a large area of edematous tissue surrounds the remaining normal ovarian structure, including follicles at all stages and occasionally corpora lutea and corpus albicans. In the stroma near the edematous area, focal pigmentation cells or focal fibrous hyperplasia can sometimes be seen, and the medulla area lymphatic and blood vessels are highly dilated.

　　There have been reports of severe ovarian edema complicated with pleural effusion, peritoneal effusion, and other manifestations of Meige syndrome. Ovarian edema can also compress glandular cells, mild compression can increase the secretion of glandular cells, while severe compression can lead to atrophy of glandular tissue, thus weakening the secretory function. For patients with pleural effusion, respiratory function is often impaired, and for patients with peritoneal effusion, there may be symptoms such as abdominal distension and discomfort, as well as decreased urine output.

　　Most patients with severe ovarian edema experience abdominal pain or pelvic pain, accompanied by abdominal distension, and some may present with acute abdominal pain. Some patients have irregular menstrual periods or amenorrhea. 10% of patients have masculinization symptoms with increased serum testosterone levels. Gynecological examination may reveal a mass in the adnexa, 90% of ovaries show unilateral enlargement, and about half of the patients have partial or complete ovarian torsion.

　　The etiology of severe ovarian edema may be due to ovarian mesenteric torsion, which affects the lymphatic and venous return of the ovary, causing water to accumulate in the ovary. A few cases are due to the hyperplasia of stromal cells in the ovarian cortex, which increases the volume and weight of the ovary and leads to torsion. Therefore, this disease cannot be prevented directly. It is appropriate to have some physical activity in daily life, but it should be avoided to have intense activities that affect the position of the ovary. At the same time, attention should be paid to reproductive hygiene to avoid pelvic inflammatory disease affecting the function of the ovary.

　　According to the patient's clinical manifestations, symptoms, and the following examination results, it is not difficult to make a diagnosis.
　　1. Laboratory examination:Hormonal level detection.
　　2. Other auxiliary examinations:Ultrasound examination, laparoscopic examination, histopathological examination.

　　The dietary注意事项 for patients with severe ovarian edema include the following aspects:

　　1. Reduce the intake of salt, eat less salted vegetables, bean curd, salted fish, cured meat, salted eggs, etc.

　　2. Control the intake of water.

　　3. Eat more high-protein and nutritious foods, such as lean meat, fresh fish, eggs, dairy products, etc.

　　4. Eat more warm foods and avoid cold and cool foods.

　　5. Eat more diuretic and dampness-relieving foods and drinks, such as soy milk, tea, etc.

　　6. Eat less or no indigestible and gas-forming foods, such as fried glutinous rice cakes, sweet potatoes, onions, potatoes, etc.

　　The treatment method for severe ovarian edema should be determined according to the degree of ovarian enlargement, whether the ovarian mesentery is twisted, whether the mesenteric vessels are embolized, whether the opposite ovary is normal, whether there are endocrine abnormalities, and whether the patient wants to have children or not. Generally, ovarian wedge resection can be performed, and frozen section pathological examination can be sent during the operation to make an accurate diagnosis. Ovarian multi-point puncture and fluid drainage can also be performed, and ovarian fixation can be added because the cause of severe ovarian edema is often intermittent torsion.