Ovarian tumor rupture causing massive hemoperitoneum: an unusual complication of colonoscopy - 23/08/11
Doi : 10.1016/j.gie.2007.12.045
| Commentary Thecoma (Gr: theka, box) and fibroma are types of ovarian stromal tumors; the former is composed of lipid-containing cells, the latter of spindle, oval, or round cells that form collagen. Differentiation between thecomas and fibromas may be difficult and, therefore, the term “fibrothecoma” frequently is used. Ovarian tumors of the thecoma/fibroma group have been reported to show myxoid change or degeneration, as a result of which they may be predisposed to rupture. Whether there was adherence of the tumor to the colon or there had been slow leakage of blood or other proteinaceous fluid that adhered to the colon and played a role in such rupture is provocative but unclear. Similarly, traction on the splenocolic ligament or the presence of a splenocolic adhesion might also have contributed to splenic laceration, which has been reported to complicate colonoscopy in about 50 cases to date. The playwright, poet, novelist, and dramatist Johann Wolfgang von Goethe (1749-1832) said, “In nature we never see anything isolated, but everything in connection with something else which is before it, beside it, under it, and over it.” He might just as well have been talking about this patient’s adhesions. Lawrence J. Brandt, MD Associate Editor for Focal Points |
© 2008
American Society for Gastrointestinal Endoscopy. Publié par Elsevier Masson SAS. Tous droits réservés.
Vol 67 - N° 7
P. 1177-1178 - juin 2008 Retour au numéro
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