Ascites, elevated CA 125, and a large adnexal mass with an enteroovarian fistula

Obstet Gynecol. 2006 Sep;108(3 Pt 2):764-6. doi: 10.1097/01.AOG.0000195064.34825.ef.

Abstract

Background: Rectovaginal and vesicovaginal fistulae occur commonly in human immunodeficiency virus (HIV)-positive women and typically present with a characteristic vaginal discharge.

Case: We report a case of a jejunal-ovarian fistula presenting as suspected malignancy in a 38-year-old woman with HIV. The patient presented with ascites, moderately elevated CA 125, and a 12-cm adnexal mass. She was expedited to surgery secondary to a persistent pelvic mass and the patient's desire for definitive treatment. We believe the patient's immunocompromised state caused a microperforation in the small bowel, which subsequently formed a fistula to the ovary. The patient's left adnexa was removed, along with a 3-cm portion of small bowel.

Conclusion: Uncommon entities should be included in the differential diagnosis of pelvic masses in immunocompromised women.

Publication types

  • Case Reports

MeSH terms

  • Adnexa Uteri / pathology*
  • Adult
  • Ascites
  • CA-125 Antigen / blood*
  • Diabetes Complications
  • Fallopian Tubes / surgery
  • Female
  • Fistula / complications
  • Fistula / diagnosis*
  • Fistula / surgery
  • HIV Infections / complications*
  • Hispanic Americans
  • Humans
  • Jejunal Diseases / diagnosis*
  • Jejunal Diseases / microbiology
  • Jejunal Diseases / surgery
  • Obesity, Morbid / complications
  • Ovarian Diseases / diagnosis*
  • Ovarian Diseases / surgery
  • Ovariectomy
  • Tomography, X-Ray Computed

Substances

  • CA-125 Antigen