Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-08T02:34:29.215Z Has data issue: false hasContentIssue false

15 - Emergencies and treatment-related complications in gynaecological oncology

Published online by Cambridge University Press:  05 August 2014

Janos Balega
Affiliation:
Birmingham Women’s Healthcare NHS Trust
Kavita Singh
Affiliation:
Birmingham Women’s Healthcare NHS Trust
Nigel Acheson
Affiliation:
Royal Devon and Exeter Hospital
David Luesley
Affiliation:
City Hospital, Birmingham
Get access

Summary

Introduction

Gynaecological cancers are more common in postmenopausal and elderly women. Most treatments in gynaecological oncology are instituted as elective procedures but acute presentations are not uncommon. Emergencies in gynaecological oncology are influenced by the site of cancer, stage of disease, presence of associated comorbidities and the treatment received. Emergencies can be medical or surgical.

Cancer-related emergencies

COMPLICATIONS RELATED TO ADNEXAL MASSES

Acute abdominal pain

The causes of acute abdominal pain associated with an adnexal mass are torsion, infarction, rupture and haemorrhage. Twisting of the ovarian pedicle results in torsion of the cyst causing a reduced blood supply, which leads to infarction and ischaemic pain. While smaller dermoid cysts are notorious for undergoing torsion, large tumours filling the entire pelvis rarely have space to undergo torsion. Infarction can also be caused by increasing size in a solid tumour resulting in diminished central blood supply. Rapidly growing tumours can develop internal haemorrhage by stretching and tearing of the feeding blood vessels or rupture of the cyst wall with bleeding into the peritoneal cavity.

Presentation

Patients usually present with sudden onset of abdominal pain radiating to the back and the thighs. Eventually, symptoms of peritonism (guarding, rigidity, rebound) and haemodynamic instability will develop with raised inflammatory markers and anaemia.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×