P2A0 WITH KISTA OVARIUM

By :
Novaldo Yudha Shena, S.Ked
Preseptor :
dr. Bambang Kurniawan, Sp.OG
Identity patient :
• Name : Ny. F
• Age : 41 th
• Religion : Islam
• Education : SMA
• Profession : House Wife
• Date of Entry : 21 february 2020
 ANAMNESIS
• Main complaint :
There was a bump in the lower right abdomen.
• Additional Complaints:
Pain since 1 week ago.
• Current Disease History:
Os was hospitalized with complaints There was a lump in the
lower right abdomen. Os also complained of pain since 3 weeks
ago so he consul to the RSPBA Obsgyn poly. Os also said that this
complaint had only been felt since 3 weeks ago.
Past medical history :
The patient has no history of any disease.
 
Family Disease History:
The patient's family has no history of similar diseases.

Operating History : none

Allergy History : none Menstrual
History Menarche : 13 years Old
Long : 7 days
Cycle : 28 days
dressing pads / day : 2 times
Birth history

Marriage History : 1
History of contraception: implant
Generalist status :
General Conditions: Good
Awareness: Compos Mentis

Vital Sign
Blood Pressure: 110/80 mmHg
Pulse: 94 x / minute
Temperature: 36.3 C
Respiration: 20 x / minute
Weight: 67 Kg
Height: 155 cm
Physical Examination :
Head
Hair: Black, not easily pulled.
Eyes: Anemic conjunctiva (- / -), jaundice sclera (- / -), isochoric pupils 3mm /
3mm, strabismus (-), exophthalmus (-), endophthalmus (-), ptosis (-).
Ears: Normotia (+ / +), tenderness (- / -), pull pain (- / -), secretariat (- / -),
tinnitus (- / -)
Nose: Deformity (-), tenderness (-), crepitation (-), septal deviation (-), Secret
(- / -). Mouth: Cyanosis (-), no dental caries, no tongue deviation tongue is
not dirty.
Neck
• KGB enlargement: there is no KGB enlargement
• Thyroid enlargement: no thyroid enlargement
• JVP: no signs of an increase in JVP are found
• Trachea: there is no deviation of the trachea, trackea
is centrally located.
Thorak
Cardiac
Inspection: Symmetrical chest wall movement, retraction between the ribs (-),
normothorak (-), IC is not visible.
Palpation: Pain relief (-), no palpation is felt tight.
Percussion:
Right border: Upper ICS 2 linea parasternal dextra Under ICS 4 linea parasternal dextra
Left border: Upper ICS 2 line parasternal sinistra Under ICS 4 linea midclavivularis
sinistra
Upper border: ICS 2 linea parasternal sinistra

Auscultation: Regular heart sounds I and II, murmurs (-), gallops (-)
Lungs
Inspection : Symmetrical
Palpation : Fremitus sounds + / +
Percussion : Sonor in both lung fields
Auscultation: vesicular breath sounds (+ / +), ronkhi.

Abdomen
• Inspection: There is a lump in the lower right abdomen.
• Palpation: Feels a mobile lump in the lower right abdomen with a springy consistency.
• Percussion: (-)
• Auscultation: (-)
Genital : (-)
Ekstremitas : Leg edema (- / -)
OBSTETRY STATUS

External Inspection
Inspection: There is a lump in the lower right abdomen.
Palpation: Feels a mobile lump in the lower right abdomen with a springy
consistency.
Auscultation: -
Internal inspection
• Vaginal toucher: -
• Inspekulo: -
Supporting examination : USG

• In this case, ultrasound results were

found for ovarian cysts.
• Ultrasound needs to be done to
determine the location and extent of
cystic or solid tumors, fluid in the
abdominal cavity that is free and not.
• Ultrasound is the primary diagnostic
imaging tool for ovarian cysts.
Laboratorium
Laboratorium
Post OP
 Work Diagnosis :

P2A0 With KISTA OVARIUM

Follow Up pre OP :
Follow Up Post OP :
Last Follow Up :
 Problem :
1. Whether the diagnosis in this patient is correct?
2. What are the risk factors in this case?
3. Why cysts can occur?
4. What is management in this patient?
 Is this patient's diagnosis correct?

• The patient came to the OBSGYN RSPBA on Friday, 21 February, at 15:10 WIB with
complaints of a lump on the right side of the lower abdomen. The patient does not complain
of refuted pain, nausea and vomiting.
• On examination of vital signs, it was found that the general condition was moderate pain,
compos mentis awareness, and vital signs: blood pressure 120/90 mmHg, pulse: 98 x /
minute, temperature: 36.2 o C, respiration: 22 x / minute.
• On physical examination, inspection shows that a lump in the lower right abdomen is visible.
At the time of palpation found a lump that can be moved, with a springy consistency.
• During the USG investigation, the case was found Mrs. F 41 years with Dextra Ovarian Cyst
based on the results of history taking, physical examination.
• Cysts are growths in the form of pockets (pockets, pouches) that grow in certain parts of the
body. Ovarian cyst is a sac filled with fluid or semisolid material that grows in the ovary.
• Ovarian cysts are found when the patient has an abdominal ultrasound.
 What are the risk factors in this case?

Risk factors for ovarian cysts:

• a. Previous history of ovarian cyst
• b. Irregular menstrual cycles
• c. Increased distribution of upper body fat
• d. Early Menstruation
• e. Fertility rate.

Vol. 3 | No. 3 | Desember 2019 | Jurnal Medical Profession (MedPro) 227

 Why cysts can occur?
Every day, a normal ovary will form several small cysts called the Follicle de Graff. In
the middle of the cycle, dominant follicles with a diameter of more than 2.8 cm will
release mature oocytes. A ruptured follicle will become the corpus luteum, which
when mature has a 1.5 - 2 cm structure with a cyst in the middle. If fertilization does
not occur in the oocytes, the corpus luteum will experience progressive fibrosis and
shrinkage. However, if fertilization occurs, the corpus luteum will first enlarge then
gradually shrink during pregnancy. (5,10)

Ovarian cysts that originate from the normal ovulation process are called functional
cysts and are always benign. Cysts can be follicular and luteal, sometimes called
thecalutein cysts. These cysts can be stimulated by gonadotropins, including FSH and
HCG. (2,6)
 What is management in this patient?

In this case the treatment is

carried out, namely the
management is done based on
therapy from the obsetric &
gynecology department.
Laparotomy surgery is performed
on patients.
 Cyst sized
• 10 x 12 cm

Colored:
• dark gray
 Last Therapy :

• cefadroxyl 3x1
• As. Mefemanat 3x1
• Inbion 1x1
• Antasyd syr 3x1 cth / oral
ANY QUESTION
MY FRIEND.!
THANK YOU