Pearls and Pitfalls in Abdominal Imaging
We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
Imaging description
Peritoneal inclusion cysts are collections of ovulatory fluid that are trapped by peritoneal adhesions around the ovary. This pathophysiology leads naturally to the three features that suggest the diagnosis of a peritoneal inclusion cyst:
The patient is of reproductive age (i.e., ovulating).
The patient usually has known risk factors for adhesions, such as prior pelvic surgery, endometriosis, or pelvic inflammatory disease.
A fluid-filled structure that surrounds or abuts an ovary is seen in the pelvis at cross-sectional imaging. The fluid typically conforms to the outline of the pelvic peritoneal cavity (Figure 73.1) [1,2]. Ultrasound may demonstrate a spiderweb pattern of fine internal septations (Figure 73.2) [3].
Importance
The cystic and solid appearance of a peritoneal inclusion cyst in combination with the surrounded ovary may result in consideration of adnexal malignancy, resulting in unnecessary surgery and patient anxiety. Correct identification of a peritoneal inclusion cyst should result in conservative therapy rather than salpingoophorectomy.
Typical clinical scenario
Peritoneal inclusion cysts are typically detected when pelvic imaging is performed in a woman of reproductive age with a history of prior pelvic surgery (Figure 73.3), endometriosis (Figure 73.4), or pelvic inflammatory disease.
Email your librarian or administrator to recommend adding this book to your organisation's collection.