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What Are The Symptoms Of Ruptured Ovarian Cyst?

Let's first define what a cyst is. A cyst is an abnormal collection of fluid in a sac. So an ovarian cyst means that there is an abnormal cavity in the ovary which has an abnormal collection of fluid. The symptoms of a ruptured ovarian cyst are a sudden onset of one-sided, lower abdominal pain which is often felt during strenuous activities like exercise or sexual intercourse. Light vaginal bleeding may also occur due to a fall in the level of ovarian hormones.

What Should Your Gynecologist Be Worried About?

Firstly, your OBGYN should consider whether or not it is a ruptured ectopic pregnancy, which has a similar clinical presentation.

Secondly the gynecologist has to establish whether you can be managed conservatively with just watchful waiting or whether surgical intervention is needed.

Other diagnoses which need to be considered are:

  • Mittelschmerz (German for "middle pain") - It is when a woman experiences mid-cycle pain and is usually due to normal follicular enlargement just prior to menstruation. The pain is usually mild and one-sided. It may last for a few hours to a few days.

  • Ectopic pregnancy is the presence of pregnancy outside of the uterine cavity.

  • Ovarian torsion occurs when the ovary twists about its stalk.

  • Degenerating leiomyoma. Leiomyoma is nothing but a fibroid or abnormal clumps of uterine muscle.

  • Pelvic inflammatory disease.

  • Acute endometritis is an infection of the inner lining of the uterus.

  • If there is a suspicion of ovarian cyst rupture and you don't have low blood pressure, fast heart beat, fever, or severe abdominal pain , raised white cell count or ultrasound evidence of enlarging collection blood in the abdomen, then the cyst rupture is said to be uncomplicated.

So if you have uncomplicated cyst rupture, the management is conservative rather than surgical.

If the cysts are large and persistent, there could be a possibility that you may require surgery so that a diagnosis can be established. Surgery also may be required if there is a suspicion of cancer.

Emergency surgery may be needed to control bleeding. Inside the operation theater, after the gynecologist has controlled the bleeding, a section of your ovarian tissue is sent frozen to the pathology lab for analysis while you are still on the operating table.

If you have not reached menopause and the pathology report comes in as "benign ovarian cyst", there is a trend nowadays, well-founded in science, to preserve the ovarian tissue by just removing the cyst and not removing the whole cyst in a procedure known as cystectomy. Consultation of a gynecologist oncologist is encouraged when there is a suspicion of cancer on the pathology report.

It is also suggested that emergency surgical intervention be performed for a ruptured dermoid cyst. Dermoid cysts are pre-cancers arising from a special type of cells from the ovary known as germ cells.

These germ cells have the capacity to form new type of cells. Strangely, this cyst may contain teeth, hair, skin cells. Rupture of these cysts may cause extrusion of cheesy material into the abdominal cavity which can cause more bleeding and inflammation of the inner lining of the abdominal cavity known as chemical peritonitis.

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