Investigation and work-up
Initial laboratory investigations revealed normal total leukocyte count (10,300/ mm3, normal range: 4000-11000/mm3), low hemoglobin concentration (6.2 g/dl; normal range: 12-18), decreased packed cell volume (19.5%, normal range: 36-54%). All other blood investigations were within normal limits. Her urine pregnancy test done was negative. Her beta-HCG (Human Chorionic Gonadotropins) levels were normal. Ultrasonography showed twisted, enlarged, oedematous, thickened right ovary with reduced blood flow. The patient’s left ovary was normal.
Based on clinical history, physical examinations, laboratory investigations, and imaging, the pre-operative diagnosis of the torsion of right dermoid cyst was made and she was planned for exploratory laparotomy and right ovary reconstruction.