Korean J Radiol.  2001 Sep;2(3):164-170. 10.3348/kjr.2001.2.3.164.

Sclerotherapy of Peritoneal Inclusion Cysts: Preliminary Results in Seven Patients

• Jeong JY
• Kim SH

• KMID: 754102
• DOI: http://doi.org/10.3348/kjr.2001.2.3.164

Abstract

OBJECTIVE
To evaluate the technical feasibility and the clinical effectiveness of sclerotherapy for the treatment of peritoneal inclusion cysts (PICs). MATERIALS AND METHODS: Between June 1996 and February 2001, eight PICs in seven female patients aged 28-43 (mean, 36) years were instilled with sclerosant (povidone-iodine in three, ethanol in three, both povidone-iodine and ethanol in one). All seven patients subsequently experienced less abdominal pain. After drainage via an 8.5-Fr pigtail catheter inserted in the PICs (transabdominally in six cases, transvaginally in one), sclerosant equivalent in volume to about one-third that of drained fluid was introduced daily until the drained volume was less than 5ml. Follow-up by means of clinical procedures and ultrasound was performed every three months, at which time the success rate, possible complications and recurrence were determined. RESULTS: Sclerotherapy was technically successful in all seven patients, though immediately after the procedure, minor complications were noted in three patients (mild pain in two, mild fever in one). During the follow-up of 4-60 (mean, 24.7) months, sclerotherapy proved successful and without long-term complications in all seven patients: lower abdominal pain disappeared and the diameter of the cysts decreased more than 50%, with complete regression in four cases. During the follow-up period there was no recurrence. CONCLUSION: Sclerotherapy following catheter insertion is technically feasible and effective for the treatment of PICs.

Keyword

Pelvis, cysts; Pelvis, interventional procedures; Pelvis, US; Ovary, cysts

MeSH Terms

Adult
Cysts/diagnosis/*therapy
Female
Follow-Up Studies
Human
Magnetic Resonance Imaging
Peritoneal Diseases/diagnosis/*therapy
Sclerosing Solutions
*Sclerotherapy
Support, Non-U.S. Gov't
Time Factors
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 A 37-year-old woman who underwent total abdominal hysterectomy for uterine leiomyoma ten years earlier presented with lower abdominal pain (Patient 1). A. Enhanced CT shows an elongated cystic mass with no solid component on the left side of the pelvis (arrows). B. Transabdominal ultrasonogram of the pelvis in the transverse plane indicates a persistent cystic mass with internal septation (arrow-heads) after simple aspiration. The left ovary may be observed (arrow). C. An 8.5-Fr pigtail catheter was introduced into the lesion transabdominally, and povidone-iodine was used for sclerotherapy. D. Transvaginal ultrasonogram obtained 54 months after the procedure shows scanty fluid (arrows) around the left ovary (LO).

• 

  Fig. 2 A 28-year-old woman who had taken anti-tuberculosis medication for tuberculous peritonitis seven years earlier presented with lower abdominal pain (Patient 3). A-C. T2-weighted (A), T1-weighted (B), and contrast-enhanced T1-weighted (C) MR images of the pelvis show a cystic mass 13cm in diameter. On the right side of the huge cystic lesion, the intact left ovary (arrow) is noted; the right ovary (curved arrow) is normal. D. Transvaginal ultrasonogram reveals a cystic mass encircling the left ovary (arrow), which is displaced to the right of the pelvis. (This image was obtained transvaginally, and the ultrasonic probe is displayed at the top.) E. An 8.5-Fr pigtail catheter was inserted transabdominally. Cytologic examination of the drained fluid, prior to sclerotherapy with absolute ethanol, revealed no evidence of tuberculosis or malignancy. F. Transabdominal ultrasonogram in transverse plane obtained seven months later shows a 4 cm-sized cyst with progressive reduction in size (white arrow). The right ovary is also visible (open arrow).

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