It was not possible to lift with one hand so he used both, for it was bigger than an average baby whom he had helped out into the world many a time.
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| Dr. Krishan Silva |
This was a huge ovarian cyst that an averagely-built girl, just getting into womanhood at 18 years old and unmarried, had been carrying around, says Consultant Obstetrician and Gynaecologist Dr. S.A.C. Krishan Silva who operated on her last Monday to relieve her of her agony.
When she was in Ward 8 of the Elpitiya Base Hospital, she looked more pregnant than many of the mothers awaiting delivery, it is learnt.
The massive cyst which weighed 10.5 kg and was 45cmX30cm had originated from her right ovary and grown into her abdominal cavity, the Sunday Times learns.
Earlier admitted to the surgical ward on September 18 with a history of severe abdominal pain and shortness of breath, she had been referred to the Gyn and Obs Ward where after a clinical examination Dr. Silva’s team had come to the conclusion that it was an ovarian cyst. The ultra-sound scan by Dr. Silva on September 19 had confirmed the diagnosis and she went under the scalpel the next day.
Working as a domestic help in a house in Galle, the girl from Elpitiya had complained of stomach issues, but no one had taken much notice. She had been popping paracetamol to keep the pain at bay.
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| The ovarian cyst that had to be lifted with the aid of both hands. |
Although she had said that her tummy became bigger and bigger within the last month, the doctors believe that the cyst had been growing for over a year. Usually. About 2-3% of women develop cysts due to one reason or another, it is learnt.
Usually, the cut in a caesarian section is horizontal, across the abdomen from right to left below the navel, but to remove the cyst Dr. Silva and his medical and nursing team, ably supported by Consultant Anaesthetist Dr. Sandhya Gamage, had to make a deep incision vertically, running from above the navel to below, the Sunday Times understands.
The extrication of the massive cyst was difficult and had to be done carefully -- that is why Dr. Silva used both his hands. To make matters more complex, glue-like mucus or mucinous material from the cyst had flowed into the abdominal cavity, acting as an adhesive and pasting the bowel and organs together.
It took us nearly two hours to do the surgery, says Dr. Silva who not only removed the cyst, but also the affected right ovary and fallopian tube as well as about one litre of mucous material.
If the cyst was not removed the patient would have gone into Pseudomyxoma Peritonei which only older women are prone to, explains Dr. Silva, adding that a biopsy of the cyst is being carried out at the Maha Modera Hospital.
But from the look of it macroscopically, it seemed benign, rather than cancerous, says this Gynaecologist who has never seen such a big one though many are the cysts he has removed. |
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