The cyst of the yellow body, as a rule, arises at the place of the bursted follicle (the yellow body, which did not regress) as a result of the accumulation of liquid in it. The fluid can sometimes contain blood. If the yellow body exceeds the size of 3 cm in diameter it is already a cyst, the average size of the cyst of the yellow body is 6 8 cm in diameter. The incidence of such cysts is small only 2 5.
They can occur at any age – from 16 to 50 years. The causes of cysts of the yellow body are not fully understood. Scientists suggest that, perhaps, the cause of their occurrence is a violation of blood and lymph circulation in the yellow body.
Cysts of the yellow body are formed in the presence of a two-phase menstrual cycle.
It is common knowledge that the ovarian’s yellow body is a temporarily existing gland of internal secretion of the female body that produces the hormone progesterone and is formed immediately after ovulation. The gland is called the yellow body because it has the corresponding yellow color on the cut. The yellow body is formed in the luteal phase of the menstrual cycle immediately after the release of the oocyte from the follicle from special granulosa-like cells of the ovarian follicle.
The yellow body of the ovary is formed under the influence of the luteinizing hormone of the anterior lobe of the pituitary gland. The yellow body produces estrogen, progesterone and the actual yellow body hormone. In the second phase of the menstrual cycle, under the influence of progesterone, the endometrium of the uterus prepares for a possible pregnancy. If fertilization does not occur, after a few days the gland begins to decrease and, regenerating into a scar, produces less progesterone, which eventually leads to the onset of menstruation.
If fertilization has occurred, the chorionic hormone of the yellow body retains its activity for 10-12 weeks. while developing progesterone, which is necessary for the development and preservation of pregnancy. The yellow body stimulates the growth of the endometrium and prevents the development of new eggs and the onset of another menstruation.
Symptomatology of the cyst of the yellow body.
is expressed weakly, the cyst for a long time almost nothing reveals itself. Very often such cysts grow for 2 3 months, and then suddenly and unreasonably undergo involution (reverse development, disappearance). Occasionally, patients with a yellow body cyst have abnormalities of the menstrual cycle in the form of delays in menstruation, too abundant or vice versa, prolonged menstruation, and sometimes painful lower abdominal pain may occur.
Among the complications, cysts of the yellow body are noted: torsion of the cysts and cyst rupture as a consequence of a hemorrhage into its cavity.
The most frequent complication of cysts is a hemorrhage into her cavity, this occurs at the stage of development of the yellow body. In this case, there is bleeding, and quite abundant.
Symptomatic disease becomes pronounced. it usually has the form of a picture of an acute abdomen: suddenly, against the background of apparent health, acute cramping pains in the abdomen of a spilled character appear (across the entire surface of the abdomen), nausea appears. then vomiting, the patient’s stomach is strained, painful on palpation (dappled abdomen), positive symptoms of irritation of the peritoneum (Shtetkin Blumberg), soreness with pressure on the front abdominal wall and sudden release, stool retention, abnormality of gases, intestinal auscultation observed disappearance the usual intestinal peristaltic noise is a symptom of deathly silence.
In the future, the condition worsens even more: signs of severe intoxication of the body appear, facial features sharpen, the pulse becomes fastened and weakened, the pale skin and mucous membranes appear, a cold, sticky sweat covering the face and body appears. If the patient does not provide qualified medical assistance on time and is not taken to hospital, she may die.
Torsion of the cyst’s legs happens much less often. Its symptoms depend on the rate of development of torsion and the degree of its severity. With the gradual formation of torsion and turning it by 180, blood circulation is disturbed only in the venous bed, while blood flows through the arteries. This contributes to a significant increase in the cyst, the accumulation of fibrin on its surface and the formation of an adhesive process between the omentum and the intestine, as a result of which the cyst loses its mobility.
When the cyst of the cyst is twisted, 360 inflow and outflow of blood through the veins and arteries cease, as a result of which ischemic and necrotic changes appear in the cyst, and when bacterial microflora is attached, peritonitis may develop. The torsion of the cyst’s legs is manifested by a sharp pain in the lower abdomen, more pronounced on the side of the lesion. Sometimes there is nausea and vomiting, fever, a quickening of the pulse, the stomach becomes tense, painful on palpation. There is a positive symptom of irritation of the peritoneum.
When a vaginal examination behind the uterus or lateral from it, an oval form is found tugoelastic formation, limited mobility, sharply painful upon palpation and displacement.
The diagnosis of the cyst of the yellow body is made on the basis of an anamnesis of the disease, patient complaints, gynecological examination results, ultrasound and laparoscopy.
To accurately diagnose the presence of a yellow body cyst, a dynamic ultrasound is performed in the first phase of the menstrual cycle. In the presence of a yellow body cyst, the woman’s condition is monitored for several menstrual cycles (usually 2-3), during this period the cyst can be involuted and completely disappear.
If the involution does not occur, the question of urgent surgical intervention is solved, since at any time the cyst can give complications: a hemorrhage into the cyst cavity or a torsion of the legs. Sometimes the cyst is diagnosed absolutely randomly during ultrasound: it looks like a capsule with a dense shell, the contents of which gives multiple echopositive signals.