Authors: Thomas Kirengo , Samra Ali , Samuel Ghattas , Mostafa AbdelKarim , Mohiuddin Kamal , Sabina Kondokhar , Joseph Mechery , Ali Murtada ,

Abstract

Background: Mature ovarian cystic teratomas (MOCT) are the most common benign ovarian tumours. They are mainly asymptomatic (60%) but can in rare cases (<1%) complicate by forming a fistula into adjacent structures such as the bowel. Patients with fistulating ovarian teratomas are typically managed surgically, most often requiring laparotomy.

Case Presentation: We report a case of an 18-year-old woman who presented with vague abdominal and gynaecological symptoms. She expelled a mass with hair and teeth per rectum which was later confirmed as a MOCT.  We managed her conservatively as a collaboration with colorectal and gynaecology teams. At one-year follow-up, she remained asymptomatic with no radiological evidence of a residual fistula.

Conclusion: This case highlights the diagnostic challenges in MOCT with a bowel fistula. We demonstrate that conservative management may be a viable option in select patients.

Keywords: Mature ovarian cystic teratomas (MOCT), Bowel Fistula, Case report, Non-operative treatment