Pelvic Peritoneal Inclusion Cyst: Ultrasound Diagnosis and Management

Original Article



Pelvic peritoneal inclusion cysts are rarely encountered in practice.


We report four cases with pelvic peritoneal inclusion cysts with their management.


Female patients with history of abdominal pain and infertility were diagnosed with peritoneal inclusion cyst on ultrasound.


They were operated by laparoscopy or laparotomy.


Peritoneal cysts are rare in practice. They are related to endometriosis and adhesions of previous surgeries or infections. They are diagnosed on ultrasound by irregular cyst-like structure separable of the ovary. It is better to be surgically removed to avoid recurrence especially if persistent on conservative management. During surgery deroofing is needed with marsupilization with out dissection of the cyst to avoid retroperitoneum structures injury or ultrasound guided aspiration under sedation. If diagnosis is missed on ultrasound, during surgery it is suspected by puncture and evaluation of the cavity for normal peritoneum of douglas pouch with separable ovary or thin transparent cyst wall with no plane of separation for dissection from roof especially if frozen pelvis by adhesions. It is in opposite to the thick wall of ovarian tissue on cystectomy with identifiable plane of dissection.


Cyst Ultrasound Peritoneum Surgery 


Compliance with Ethical Standards

Conflict of interest

The author declares no conflict of interest.

Ethical Standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from the patient included in the study.

Ethical Disclosure

The author declares that the procedures followed were in accordance with the regulations of the relevant clinical research ethics committee and with those of the Code of Ethics of the World Medical Association (Declaration of Helsinki).

Confidentiality of Data

The author declares that they have followed the protocols of their work center on the publication of patient data.

Right to Privacy and Informed Consent

The author has obtained the written informed consent of the patients or subjects mentioned in the article. The corresponding author is in possession of this document.


  1. 1.
    Jain KA. Imaging of peritoneal inclusion cysts. Am J Roentgenol. 2000;174:1559–63. doi: 10.2214/ajr.174.6.1741559.
  2. 2.
    Hoffer FA, Kozakewich H, Colodny A, et al. Peritoneal inclusion cysts: ovarian fluid in peritoneal adhesions. Radiology. 1988;169:189–91.CrossRefPubMedGoogle Scholar
  3. 3.
    Koninckx PR, Renaer M, Brosens IA. Origin of peritoneal fluid in women: an ovarian exudation product. Br J Obstet Gynaecol. 1980;87:177–83.CrossRefPubMedGoogle Scholar
  4. 4.
    Verger C, Luger A, Moore HL, et al. Acute changes in peritoneal morphology and transport properties with infectious peritonitis and mechanical injury. Kidney Int. 1983;23:823–31.CrossRefPubMedGoogle Scholar
  5. 5.
    Sohaey R, Gardner TL, Woodward PJ, et al. Sonographic diagnosis of peritoneal inclusion cysts. J Ultrasound Med. 1995;14:913–7.CrossRefPubMedGoogle Scholar
  6. 6.
    Inman DS, Lambert AW, Wilkins DC. Multicystic peritoneal inclusion cysts: the use of CT guided drainage for symptom control. Ann R Coll Surg Engl. 2000;82:196–7.PubMedPubMedCentralGoogle Scholar
  7. 7.
    Lipitz S, Seidman DS, Schiff E, et al. Treatment of pelvic peritoneal cysts by drainage and ethanol instillation. Obstet Gynecol. 1995;86:297–9.CrossRefPubMedGoogle Scholar
  8. 8.
    Birch DW, Park A, Chen V. Laparoscopic resection of an intra-abdominal cystic mass: a cystic mesothelioma. Can J Surg. 1998;41:161–4.PubMedPubMedCentralGoogle Scholar
  9. 9.
    Sethna K, Mohamed F, Marchettini P, et al. Peritoneal cystic mesothelioma: a case series. Tumori. 2003;89:31–5.PubMedGoogle Scholar
  10. 10.
    Jeong JY, Kim SH. Sclerotherapy of peritoneal inclusion cysts: preliminary results in seven patients. Korean J Radiol. 2001;2:164–70.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Nuzzo G, Giuliante F, Tebala GD, et al. Routine use of open technique in laparoscopic operations. J Am Coll Surg. 1997;184:58–62.PubMedGoogle Scholar
  12. 12.
    Akhan O, Karcaaltincaba M, Ozmen MN, et al. Percutaneous transcatheter ethanol sclerotherapy and catheter drainage of postoperative pelvic lymphoceles. Cardiovasc Interv Radiol. 2007;30:237–40.CrossRefGoogle Scholar
  13. 13.
    Lim HK, Cho JY, Kim SH. Sclerotherapy of peritoneal inclusion cysts: a long-term evaluation study. Abdom Imaging. 2010;35:431–6.CrossRefPubMedGoogle Scholar
  14. 14.
    Arraiza M. Primary cystic peritoneal masses and mimickers: spectrum of diseases with pathologic correlation. Abdom Imaging. 2015;40(4):875–906. doi: 10.1007/s00261-014-0250-6.CrossRefPubMedGoogle Scholar
  15. 15.
    Lee SW, Lee SJ, Jang DG, Yoon JH, Kim JH. Comparison of laparoscopic and laparotomic surgery for the treatment of peritoneal inclusion cyst. Int J Med Sci. 2012;9(1):14–9.CrossRefPubMedGoogle Scholar

Copyright information

© Association of Gynecologic Oncologists of India 2017

Authors and Affiliations

  1. 1.Department of obstetrics and gynecology, Faculty of medicineAlexandria universityAlexandriaEgypt
  2. 2.Women`s imaging unit, shatby maternity university hospitalAlexandria universityAlexandriaEgypt

Personalised recommendations