Huge mucinous cystadenoma presenting as an acute abdomen in the puerperium

摘要

A 33-year old para 4~+0 trader presented two days after delivery with severe, generalized abdominal pain associated with abdominal distension and constipation which commenced with onset of labour. She was unbooked in that pregnancy but noticed that her abdomen was larger than her previous pregnancies. She went into labour at nine months (she was unsure of her dates) and this lasted 18 hours after which she delivered a live male baby at home. The labour was difficult and she had fundal pressure applied. She, however, noticed that there was no appreciable decrease in her abdominal size after delivery. She developed severe abdominal pains which were of a different nature to the labour pains, occasioning her presentation to hospital 48 hours after delivery. Her previous pregnancies were uneventful and her past medical history was not significant. On examination, she was mildly pale, moderately dehydrated and in acute pain. Her blood pressure was 110/80 mrnHg and pulse rate was 120 beats per minute. The chest was clinically clear.