A CASE OF BOCHDALECK’S HERNIA AND A GIANT OVARIAN CYST IN A GERIATRIC PATIENT

Some authors define a giant ovarian cyst as having more than a 10 cm diameter . Huge cysts are usually benign or have a low-degree of malignancy . Laparoscopy is considered the gold standard approach to manage benign ovarian cysts but a major factor that will make the surgeon decide to perform or not perform a laparotomy is the size of the ovarian mass. We describe the case of an 86-year-old female patient diagnosed and treated for a giant ovarian cyst. The patient presented with complaints of recently aggravated pain in the left hypochondrium. The main symptom was a giant pelvic and abdominal mass that occupied all the quadrants. The CT scan identified the giant tumor as an ovarian cyst and also revealed a Bochdaleck hernia. Other investigations revealed: arterial hypertension, right bundle branch block, and chronic cardiac failure. The surgical treatment of choice was minimal laparotomy followed by suction of the content of the cyst, excision of the cyst’s wall and left adnexectomy. Despite the advanced anesthesiological risks, the patient developed no postoperative complications. Patients can be operated on successfully even in old age and in complicated cases with good perioperative anaesthetic evaluation and careful election of the surgical technique.