Massive edema of the ovary (MEO) is an extremely rare disorder affecting young females, presenting clinically with low abdominal pain due to swelling of an ovary. Only 10 cases have been recorded in the English literature since the original description by Kalstone et a1 in 1969.' Of these, only one case has been studied by ultrasound, and that was in the bistable mode.2 The following case is an example of this rather unusual condition demonstrated by gray-scale ultrasound.CASE HISTORY KG is a 19-yr-old girl who presented with low abdominal pain aggravated by bowel movements and intercourse. Pertinent physical findings were moderate tenderness over the right lower abdomen and a 5-cm tender right adnexal mass on pelvic examination. The only significant laboratory finding was a white blood cell count of 11,200. A pregnancy test was negative. U1-trasound examination showed a normal-sized uterus with normal echogenicity. There was a large, discrete pelvic mass lying behind the uterus extending to the left side. Compared with the uterus, the mass was hypoechoic, with slightly increased through transmission. A discrete, 2-cm sonolucency was seen within the mass (Fig 1-3).A pelvic inflammatory process was considered the most likely possibility, and antibiotics were given for 10 days with no clinical improvement.A repeat ultrasound examination showed no change. Laparotomy was performed and an enlarged, tense right ovary was noted at surgery, associated with torsion of the meso-ovarium. The operative diagnosis was twisted ovarian cyst.
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