When
large ovarian cysts pose problems in removal by
laparotomy, the only alternative left is to drain out
their contents, so that they may get a chance to shrink
to a manageable size. Though such instances are rather
rare now since ovarian cysts are diagnosed at an early
stage through ultrasound, laparoscopic examination, CT
scan, Magnetic Resonance, etc and taken care of, some
cases do occur still when such steps become necessary. A
case of
ovarian cyst drainage
that created uproar in the medical profession around a
year ago concerned a 37 year old lady, diagnosed with a
328 lb mucinous cystadonema in her
abdomen.
Another
incident of
ovarian cyst drainage
and drew attention recently involved a woman aged 50
years who had progressive abdominal distension for a
period of 3 years. She weighed 73.5 kg and her abdominal
girth was at 145 cm. She walked with a limp, no doubt
caused by the enormous tummy. An ultrasound exam
affirmed that there was an enormous cystic mass in the
pelvic area. Biochemical and hematological
investigations confirmed mild hypochromic microcystic
anaemia, PCV of 30, BUM, liver function, serum
electrolytes, blood sugar, RCG, blood gases from the
arteries proved within normal
limits.
Before
any major step could be taken, it was determined that
the cyst should first be drained and accordingly the
same was done in stages for 14 days; 12.5. liters was
tapped by carrying out paracentesis repeatedly every two
to three days, removing around 3 liters per day, over 6
to 12 hours. On the 15th day, the lady's
preoperative girth in the abdomen decreased to just 121
cm and her weight came down to 63
kg.
No
sedative pre-medication was prescribed before the actual
surgery while the atropine injection 0.5 was given intra
muscularly. To replace the fluid the peripheral
intravenous line and central venous was injected.
Suxamethonium (75 mg), thiopentone (125 mg) and
anesthesia was applied intravenously. The pressure of
Cricoid was also applied immediately before induction.
The No.7 oral cuffed endotracheal tube was used to
intubate the patient. Controlled ventilation with
nitrous oxide at 70% and controlled ventilation was
applied to maintain the patient. Injection pancuronium 4
mg assured muscle relaxation while the nasogastric tube
passed through. And finally, Diazepam 2.5 mg and
Pentazocine 10 mg was administered
intravenously.
Intraoperatively
the patient was given 3 units of blood and 2 liters of
crystallids and a multilocular mucinous cyst was taken
out, and this had greenish and vicious fluid of 22.5
liters. CVP (central vevenous pressure) was kept between
three to five cm of the urine and H20 output when the
surgery was over was at 1200 ml. Prostigmine (2.5 mg)
and atropine (1mg) was reversed on the patient
intravenously. She was extubated on the table and was
found to be breathing well, and later was returned to
the intensive therapy section for postoperative
treatment and care.
The holistic approach has become popular in recent years as a cure for many diseases including ovarian cysts. 'Holism' has been linked to maintaining good health for years now, but it has been integrated with the mainstream 'Health care system' is a recent development. The fact is, the holistic approach cures cysts in the ovary completely, and it also prevents its occurring through altered diet, healthy habits and change of lifestyle. Holistic method is not merely a technique adopted in curing a disease condition; it is an ideal concept for doing so, involving a mighty lot of factors that govern our bodily functions.
