Ovarian Cyst Pedicle Torsion

　　Ovarian cyst torsion refers to the twisting of the blood vessels that supply the ovarian cyst, causing the ovarian cyst to become ischemic, and even necrotic and ruptured, leading to severe abdominal pain. It is one of the gynecological acute abdominal emergencies, with about 10% of ovarian cysts experiencing torsion. It is more common in tumors with long pedicles, medium size, good mobility, and a center of gravity on one side (such as cystic teratoma, mucinous and serous cystadenoma are most prone to torsion), and often occurs during sudden changes in position, in the early stages of pregnancy, or after childbirth.

　　1. Abdominal circumference enlargement and intra-abdominal mass

　　This is the most common phenomenon in patients. Patients notice that their clothes or belts are getting tighter, and then pay attention to the increase in abdominal size, or occasionally notice it in the morning, so they press their abdomen and find a mass inside, accompanied by discomfort due to bloating.

　　2. Abdominal pain

　　If the tumor does not have complications, pain is rare. Therefore, when ovarian tumor patients feel abdominal pain, especially if it occurs suddenly, it is often due to torsion of the tumor pedicle, occasionally due to cyst rupture, bleeding, or infection. In addition, malignant cysts often cause abdominal pain and leg pain, and the pain often leads patients to seek emergency medical attention.

　　3. Menstrual disorders

　　Ovarian cysts on one side or both sides of the ovary usually do not cause menstrual disorders as they do not destroy all normal ovarian tissue. Some uterine bleeding is not endometrial, or due to the change in blood distribution in the pelvic cavity caused by ovarian cysts, leading to endometrial congestion; or due to the direct metastasis of malignant ovarian cysts to the endometrium. Menstrual disorders caused by endocrine tumors often accompany other secretory effects.

　　1. Abdominal circumference enlargement and intra-abdominal mass

　　This is the most common phenomenon in patients. Patients notice that their clothes or belts are getting tighter, and then pay attention to the increase in abdominal size, or occasionally notice it in the morning, so they press their abdomen and find a mass inside, accompanied by discomfort due to bloating.

　　2. Abdominal pain

　　If the tumor does not have complications, pain is rare. Therefore, when ovarian tumor patients feel abdominal pain, especially if it occurs suddenly, it is often due to torsion of the tumor pedicle, occasionally due to cyst rupture, bleeding, or infection. In addition, malignant cysts often cause abdominal pain and leg pain, and the pain often leads patients to seek emergency medical attention.

　　3. Menstrual disorders

　　Ovarian cysts on one side or both sides of the ovary usually do not cause menstrual disorders as they do not destroy all normal ovarian tissue. Some uterine bleeding is not endometrial, or due to the change in blood distribution in the pelvic cavity caused by ovarian cysts, leading to endometrial congestion; or due to the direct metastasis of malignant ovarian cysts to the endometrium. Menstrual disorders caused by endocrine tumors often accompany other secretory effects.

　　4. Compression symptoms

　　A large ovarian cyst can cause respiratory distress and palpitations due to compression of the diaphragm, and ovarian cysts with a large amount of ascites can also cause such symptoms; however, some patients with respiratory distress due to ovarian cysts are caused by pleural effusion on one or both sides, and often accompanied by ascites.

　　1. Ovarian cysts are a type of tumor, and the acidic environment within the ovary is conducive to tumor growth. Therefore, it is recommended to eat more alkaline foods (such as zucchini, bamboo shoots, kelp, and tomatoes) to neutralize these acidic environments, which can effectively reduce the rate of cyst growth.

　　2. It is incorrect for many young women to frequent nightlife spots, smoke and drink inside, as these are not advisable. Ovarian cyst patients not only need to quit smoking and limit alcohol consumption, but also pay attention to not eating salty and spicy foods, as well as excessively hot or cold foods.

　　3, Maintain a good mental state, female patients should maintain a good mental state to face the disease, which has a good effect on the treatment of the disease.

　　1, Ultrasound examination

　　Ovarian cyst ultrasound examination can determine the location, size, shape, and nature of the mass, indicating whether the tumor is cystic or solid, benign or malignant, and can distinguish from other diseases, which is of great significance for the diagnosis of ovarian tumors. The clinical diagnostic coincidence rate of ultrasound examination is 90%. However, solid tumors with a diameter of 1-2 cm are not easy to detect.

　　2, Cervical mucus examination and vaginal cell examination

　　Estrogen makes cervical mucus thin, with long silkiness, and appears fern-like crystals. The more obvious and thicker the fern-like crystals are, the more significant the estrogen effect is. If there are rows of ellipsoids on the smear, it indicates that under the influence of estrogen, the influence of gestational hormone has already occurred. Observe the percentage of superficial, middle, and basal cells, and the higher the percentage of superficial cells reflects the higher estrogen level.

　　3, Basal body temperature detection

　　Basal body temperature refers to the body temperature measured after a long period of sleep and wakefulness without any activity, which is the body temperature to maintain basic life activity state. Since the thermoregulatory center is extremely sensitive to gestational hormone, the general body temperature rises 2-3 days after ovulation, and a few rise on the day of ovulation. If there is no ovulation, the body temperature will continue to be at the basal body temperature.

　　4, Radiological diagnosis

　　Radiological diagnosis is assisted by abdominal X-ray, intravenous pyelography, barium swallow examination, lymphography, etc.

　　5, Cytological examination

　　Through cul-de-sac puncture, aspirate peritoneal fluid for cytological examination. During laparoscopic examination or exploratory laparotomy, fluid can be aspirated and examined at the rectouterine凹陷at the same time, which has a high accuracy for the diagnosis of malignant ovarian cysts.

　　First, dietetic recipe for ovarian cyst torsion

　　1, Yam and walnut kernel stewed hen soup

　　Ingredients: One whole hen, 40 grams of yam, 30 grams of walnuts, 25 grams of dried mushrooms, 25 grams of bamboo slices, 25 grams of ham, one whole hen, an appropriate amount of yellow wine and refined salt;

　　Method: Peel the yam, cut it into thin slices, wash the walnuts; blanch the whole hen with boiling water to remove blood and dirt, place it in a soup bowl, add 50 milliliters of yellow wine, an appropriate amount of refined salt, and 1000 milliliters of fresh soup; place the yam, walnuts, mushrooms, bamboo slices, and ham slices on top of the hen, steam for about 2 hours, and remove it when the hen is tender and ready to eat.

　　Effects: Tonify Qi and invigorate the spleen, activate blood and resolve stasis.

　　Indications: For patients with ovarian cyst torsion, accompanied by fatigue, physical weakness, shortness of breath, reluctance to speak, fatigue, more severe when moving; hidden pain in the lower abdomen, preferring to press, menstrual late, less amount, pale and dark tongue, tooth marks on the edges, thin and涩脉，belonging to Qi deficiency and blood stasis.

　　2, Water chestnut, Job's tears, and fish maw porridge

　　Ingredients: 500 grams of water chestnuts, 100 grams of raw Job's tears, 150 grams of fish maw, half a piece of dried tangerine peel, an appropriate amount of sticky rice, a little salt.

　　Method: Wash all ingredients with clean water and set aside; remove the shell of the water chestnuts and take out the meat, soak the fish maw with clean water to expand and cut into pieces; add a sufficient amount of water to a pot, bring to a boil over high heat, then add the materials and cook over medium heat until the sticky rice blooms and becomes a thin porridge, season with salt to taste and serve.

　　Effects: Invigorate the spleen and remove dampness, detoxify and disperse nodules, nourish the liver and kidney;

　　Indications: Ovarian cyst torsion, with obesity, increased amount of leukorrhea, sticky, yellow with an unpleasant smell, vaginal itching; pale red tongue with white greasy coating, slippery pulse, belong to spleen deficiency and dampness syndrome. This porridge is not drying and heating, suitable for daily consumption by the whole family, can invigorate the spleen and nourish the liver and kidney, but those with frequent nocturnal urination or enuresis are not suitable.

　　Second, what is good for the body in ovarian cyst torsion

　　1. Eat more foods with anti-ovarian tumor effects: horseshoe crab, hippocampus, turtle, dragon pearl tea, hawthorn.

　　2. For bleeding, eat goat blood, snails, light fish, cuttlefish, shepherd's purse, lotus root, mushrooms, malan tou, shi er, hickory, persimmon cake.

　　3. For infection, eat eels, warty clams, water snakes, needlefish, crucian carp, kelp, celery, sesame, buckwheat, brussels sprouts, scallion, red beans, mung beans.

　　4. For abdominal pain and distension, eat pork kidneys, myrica, hawthorn, orange cake, walnuts, chestnuts.

　　Third, what food should not be eaten for ovarian cyst torsion

　　1. Avoid smoking, alcohol, coffee, cocoa, etc.

　　2. Avoid spicy and irritating foods: scallions, ginger, chili.

　　3. Avoid moldy, charred foods, such as moldy peanuts, moldy soybeans, smoked meat, etc.

　　4. Avoid dog meat, mutton, and greasy, fried, smoked and other drying and heating foods.

　　The traditional treatment method for ovarian cyst torsion is to perform a unilateral adnexectomy, and not to perform unilateral adnexolysis and cystectomy to avoid the risk of thromboembolism from ovarian veins. Some scholars abroad have reported that 22 out of 27 patients with pregnancy and ovarian tumor torsion received conservative surgery (adnexolysis, cystectomy) and none developed postoperative thromboembolism. Jiang Jingyi et al. proposed that conservative surgery is feasible for this disease, the indications are benign cyst diameter of 4-12 cm (average 8 cm), torsion degree of 360° and no ovarian necrosis; Xu Qiliang et al. reported that 36 patients with ovarian cyst torsion were treated with ultrasound-guided aspiration of cyst fluid followed by injection of absolute ethanol and other drugs, 27 cases showed symptom relief, and they believed that after puncture, torsion could recover spontaneously.