BackgroundOf all patients undergoing emergency surgery for acute pelvic pain, approximately 2.7% of cases are caused by ovarian torsion. We report a rare occurrence of bilateral ovarian torsion in a young woman.Case presentationWe report the case of a 20-year-old white woman who presented with sudden onset of severe lower abdominal pain and nausea. Similar episodes of pain were experienced in the previous few months and diagnosed as a case of bilateral ovarian cyst. She was found to have a bilateral ovarian torsion caused by adnexal mass. She was treated by laparoscopic detorsion, left salpingo-oophorectomy, and right cystectomy.ConclusionThis case highlights the need to perform an early laparoscopic surgical intervention in cases of bilateral ovarian mass because of the greater chance for their torsion and subsequent effects on fertility.

The giant ovarian serous cystadenoma is a rare finding and often benign. The use of the laparoscopic approach versus open approach for the management of huge ovarian cysts is controversial. We report a case of a 27-year-old woman with a history of increasing abdominal girth over a period of two years along with radiological investigations revealed a large tumor arising from the right ovary treated by complete laparoscopic extirpation of a giant ovarian cyst. The complete laparoscopic approach for huge cyst is a feasible treatment when having a normal tumor marker profile and benign imaging appearance. In addition to the advantages of laparoscopic surgery, it is less invasive, with perfect cosmetic outcome and shorter hospital stay, which are particularly important for young women.

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Background: Cesarean scar pregnancy is a rare, potentially life-threatening complication in patients with prior cesarean delivery. Vaginal bleeding is a common presenting symptom. Case Report: A 23-year-old female who presented with mild vaginal bleeding was diagnosed by transvaginal ultrasound with a viable cesarean scar pregnancy of 7 weeks' gestation. After the sac content was suctioned through a transvaginal approach under ultrasound guidance, the patient was injected with 50 mg local and 25 mg systemic methotrexate. One week later, a repeat systemic methotrexate dose of 50 mg was administered. The patient's beta human chorionic gonadotropin (hCG) levels were followed weekly until a negative beta hCG level was established. Conclusion: No management approach has been universally approved for cesarean scar pregnancy; the best option depends on case presentation, surgeon experience, and available facilities. We suggest that our minimally invasive treatment is an acceptable approach, especially if embryonic cardiac activity is present. We recommend the referral of such cases to tertiary centers to avoid complications.

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