Summary
Ovarian cyst rupture presents with sudden unilateral lower abdominal pain, sometimes with nausea, bleeding, or hemodynamic instability. Diagnosis involves pregnancy testing and pelvic ultrasound showing free fluid. Unstable patients need urgent surgery for hemostasis, while stable cases are managed conservatively with analgesia and observation, with transfusion if required.
Definition
Rupture of an ovarian cyst causes acute pelvic pain due to peritoneal irritation from leakage of cyst contents.
Clinical Features
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Sudden, unilateral lower abdominal pain, often triggered by strenuous activity or sexual intercourse
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Tenderness on physical examination; adnexal mass may or may not be palpable
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Nausea, vomiting, or light vaginal bleeding may occur
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Hemodynamic instability is rare but possible, especially in patients on anticoagulants
Diagnosis
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Laboratory tests: Complete blood count to assess for anemia; pregnancy test to exclude ectopic pregnancy
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Imaging: Pelvic ultrasound often shows free fluid from cyst contents; an adnexal mass may be absent in complete rupture
Management
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Hemodynamically unstable patients: emergency exploratory laparoscopy/laparotomy to obtain hemostasis
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Suturing or cauterization of the ruptured section or cystectomy
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Consider oophorectomy in intractable hemorrhage
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Hemodynamically stable patients: conservative management with analgesics and observation
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All patients: Consider blood transfusion as needed.
احصل على التجربة الكاملة
اشترك للوصول لفيديوهات الشرح التفصيلي والبطاقات التعليمية التفاعلية وأسئلة الممارسة مع تتبع التقدم.