Peritoneal inclusion cysts seen
A sonographer posted sonograms of peritoneal inclusion cysts in a 23‑year‑old with abdominal pain, showing fluid trapped by adhesions rather than a simple cyst (x.com). The post included clinical images and brief commentary and reached audience engagement metrics listed as 19 likes, 4 reposts and about 470 views (x.com).
Peritoneal inclusion cysts are pockets of normal body fluid that get trapped by scar tissue, often around an active ovary, and can look like an ovarian cyst on ultrasound. (radiopaedia.org) Radiology references describe them as benign lesions seen mainly in premenopausal women, usually after prior pelvic surgery, infection, endometriosis, or other inflammation that leaves adhesions behind. (radiopaedia.org) On ultrasound, the key clue is that the ovary is still visible but appears caught at the edge of, or inside, a septated fluid collection — a pattern the Radiological Society of North America case archive calls the “spider-in-a-web” sign. (rsna.org) That matters because adnexal masses — growths near the ovary, fallopian tube, or nearby tissue — are common, and standard workups focus first on ruling out cancer or other urgent causes of pain. The American College of Obstetricians and Gynecologists says acute or intermittent pain is one way these masses come to attention. (acog.org) Peritoneal inclusion cysts can be mistaken for paraovarian cysts, hydrosalpinx, tubo-ovarian abscess, or ovarian tumors if the trapped-fluid pattern is missed. In the RSNA teaching case, the absence of a solid mural nodule and the eccentric, normal-appearing ovary helped separate it from ovarian malignancy. (rsna.org) The condition depends on two things happening at once: an ovary that is still producing fluid and a peritoneum — the abdominal lining — that can no longer absorb that fluid normally because adhesions have walled it off. (radiopaedia.org) Recent case literature says imaging is central to diagnosis and follow-up, and management can range from observation to drainage or surgery depending on symptoms and recurrence. One 2025 case report described symptom resolution after adhesiolysis and cyst excision in a woman with postoperative abdominal pain. (ncbi.nlm.nih.gov) The practical takeaway from the ultrasound images is that not every pelvic “cyst” is a standalone cyst. Sometimes the scan is showing fluid boxed in by old adhesions, with the ovary caught in the middle of the picture. (rsna.org)
