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Age: 26

Sex: Female

Indication: Lower abdominal pain

Negative pregnancy test

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Case #17


Findings

  • Large anechoic right ovarian lesion measuring 6.5 x 6 x 5.2 cm with posterior acoustic enhancement
  • Otherwise normal appearance of the uterus and ovaries with preserved arterial and venous spectral Doppler waveforms in both ovaries
  • Moderate to large volume free fluid layering in the pelvis with internal echoes


Diagnosis

Ruptured ovarian cyst

Sample Report

No evidence of ovarian torsion.

Moderate to large volume free fluid layering in the pelvis with internal echoes, likely representing hemoperitoneum.

Simple appearing right ovarian cyst measuring up to 6.5 cm. Given size, recommend followup pelvic ultrasound in 6-12 weeks for further assessment.


Discussion

  • Ovarian cysts are a common cause for lower abdominal pain in women of child-bearing age
  • The two major types of cysts are follicular cysts and corpus luteal cysts, both of which may become hemorrhagic
  • Physiologic cyst enlargement, intracystic hemorrhage, and cyst rupture may all be causes for pain
  • Cyst rupture or leakage typically results in simple or mildly complex free fluid, though frank hemorrhage may occur
  • In the setting of spontaneous hemoperitoneum, it is important to exclude a ruptured ectopic pregnancy, and if there is suspicion or clinical instability, the patient should be considered for laparoscopic assessment
  • Please refer to the Incidental Findings Guidelines page for an overview of recommended management for incidental adnexal lesions



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