Presented by Kristen Pepin, MD, Nisse V. Clark, MD, and Jon I. Einarsson, MD, PhD, MPH Brigham and Women’s Hospital, Boston.
This is the case of a 51-year-old G1P2 who presented for evaluation of pelvic pain.
The patient had an extensive surgical history, including a laparoscopic left salpingo-oophorectomy with right salpingostomy and excision of endometriosis. This was followed by a cesarean section, which was followed by a laparoscopic hysterectomy and right salpingo-oophorectomy for pelvic pain.
Thereafter, the patient’s pain initially got better and then recurred. Imaging was notable for possible retained ovarian tissue, and thus, the patient underwent a laparotomy and resection of a right ovarian remnant. Again, her pain resolved and again, it slowly recurred.
The patient described persistent back and right-sided pelvic pain associated with bloating. These symptoms prompted her gynecologist to perform a pelvic ultrasound, which showed a calcified ovarian remnant on the right side. She was offered surgical resection of the ovarian remnant.
The surgical plan was to remove anything that looked like ovarian tissue or scar tissue through careful dissection, even if that meant a radical excision.