Hydatid of morgagni with torsion diagnosed during cesarean delivery. A case report.
BACKGROUND
Hydatids of Morgagni are benign, pedunculated, cystic structures arising from müllerian vestiges below the fallopian tube near the fimbria. They usually are of no clinical significance unless the pedicle becomes twisted and infarction occurs.


METHODS
A 39-year-old primigravida at 41 weeks and 5 days' gestation underwent primary cesarean delivery for macrosomia and failure to descend during labor. A 4 x 3-cm hydatid of Morgagni with torsion of the pedicle was found on the left fallopian tube. Ligation of the pedicle and excision of the infarcted cyst were performed. Histology of the specimen demonstrated cuboidal epithelium with extensive hemorrhage and necrosis, consistent with an infarcted hydatid of Morgagni. All pain and symptoms experienced by the patient during the previous day were associated with the onset of labor. No specific left lower quadrant pain was reported.


CONCLUSIONS
Hydatids of Morgagni are common findings at pelvic surgery and usually of no clinical significance. Torsion of a hydatid of Morgagni is rarely reported and most likely is a rare occurrence. In this patient, torsion of the hydatid of Morgagni was possibly pregnancy related, and symptoms associated with torsion were probably masked by labor pain.
Wittich
Arthur C
AC
Department of Surgery, DeWitt Army Community Hospital, Fort Belvoir, Virginia, USA. drwittich@aol.com
D000328:Adult; D002585:Cesarean Section; D003560:Cysts / Q000196:embryology / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D009095:Mullerian Ducts / Q000196:embryology / Q000473:pathology* / Q000601:surgery*; D011247:Pregnancy; D014102:Torsion Abnormality / Q000196:embryology / Q000473:pathology / Q000601:surgery; D014591:Uterine Diseases / Q000196:embryology / Q000473:pathology* / Q000601:surgery*; D014928:Wolffian Ducts / Q000196:embryology / Q000473:pathology* / Q000601:surgery*