ABSTRACT:A 35-year-old woman with a prior history of TAH and RSO 5 years back due to adenomyosis with b/l chocolate cysts and laparoscopic left ovarian cystectomy for chocolate cyst of left ovary 1 year back was presented at our outpatient gynecology clinic 20 days back with sudden lower pelvic discomfort and vaginal bleeding. The patient underwent clinical examination which revealed presence of altered clot in vault with breech of vault in left side. USG and CECT abdomen revealed a chocolate cyst in left vault amidst rectum and bladder. A diagnosis of recurrent ovarian endometriotic cyst invading to vault was made. Laparoscopic surgery was done by retroperitoneal approach. Left oophorectomy with excision of affected vagina followed by creation of neovault by freshened vagina was done. Therefore in pelvic endometriosis care must be taken for follow-up even after hysterectomy when ovarian tissue is left out.Keywords: Hysterectomy,endometriotic cyst, vault bleeding, recurrent chocolate cyst.
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