Gastroenterologie
a hepatologie

Prevalence and associated factors of ovarian cysts among patients with Crohn’s disease

Veronika Suchá¹, Michaela Jezberová², Barbora Kadlečková³, Katarína Otottová⁴, Ľubomír Jurgoš ^{Orcid.org  1}, Soňa Kiňová ^{Orcid.org  5}, Dušan Podmanický^6,7, Zuzana Zelinková ^{Orcid.org  3}

+ Affiliation
¹ Gastroenterologická ambulancia, Gastrocentrum Bajkalská s. r. o., Bratislava
² Dr. Magnet, s.r.o., Bratislava
³ Gastroenterologické oddelenie a oddelenie digestívnej endoskopie, Interná Klinika SZU, Univerzitná Nemocnica – Nemocnica sv. Michala, Bratislava
⁴ IBD Centrum, Gastroenterologické centrum ASSIDUO, Bratislava
⁵ I. interná klinika LF UK a UN Bratislava, Slovenská republika
⁶ Chirurgické oddelenie, Univerzitná Nemocnica – Nemocnica sv. Michala, Bratislava
⁷ LF SZÚ, Bratislava

Summary

Background: There have only been a few historical studies suggesting a higher frequency of ovarian cysts among women with Crohn’s disease (CD). These cysts are mainly found incidentally during cross-sectional imaging performed to evaluate the extent of perianal and/or luminal CD. Therefore the aim of this study was to assess the prevalence of ovarian cysts in CD patients and the factors associated with these cysts. Methods: Women with CD were identified through an automated diagnosis coding system. Patients who underwent cross sectional imaging of the pelvis were further analyzed. Age, medication, and CD-related previous surgical intervention were recorded. The association of these factors with ovarian cyst (s) was tested statistically by the chi-square test. Results: Among 166 women who underwent cross-sectional imaging of the pelvis, 153 underwent magnetic resonance imaging, eight CT, and five abdominal ultrasound. Out of these patients, 10% had no immune suppressive therapy, 19% were using thiopurines, and 71% were treated with anti-TNF (tumor necrosis factor). Thirty-three percent had a history of at least one CD-related abdominal surgery. Ovarian cysts were present as incidental findings in the imaging of 35 patients. Among patients with ovarian cysts, there was significantly more anti-TNF users than among those without cysts (88 vs. 66%, respectively; p < 0,001). Independently of anti-TNF use, there was significantly more patients with a history of abdominal surgery among patients with ovarian cysts than among patients without this finding (69 vs. 24%; p < 0,001). Conclusion: Up to one fifth of Crohn’s disease patients have an incidental finding of ovarian cyst during cross-sectional imaging. This represents a two-fold higher incidence than in the healthy population. The use of anti-TNF and CD-related abdominal surgery are independent factors associated with ovarian cysts in this particular patient population.

Keywords

Crohn’s disease, anti-TNF, surgical treatment, ovarian cysts

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