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Ruptured Ovarian Cyst - Symptoms, Risks, Complications, Diagnosis and Treatment

Written by
Dr. Asha. C
and medically reviewed by Dr. Reetika

Published on May 30, 2022 and last reviewed on Sep 08, 2022   -  5 min read

Abstract

Ovarian cysts are very common, but cyst rupture should be taken seriously. This article explains the causes, symptoms, diagnosis, and treatment of ruptured ovarian cyst.

Introduction:

Mostly, ovarian cysts rupture as a regular part of the menstrual cycle. During ovulation, the follicle or cyst containing the egg ruptures and releases an egg. In most cases, ruptured ovarian cysts do not require much treatment or only medications, but surgery may be necessary in severe cases.

What Is an Ovarian Cyst?

Ovarian cysts are fluid-filled sacs inside or on the surface of the ovary. Every woman has two ovaries which look like an almond, on each side of the uterus. In the ovaries, the development and maturation of eggs happen. The eggs are released every month during the childbearing years. As a result, ovarian cysts are common in most women during this time. However, most present with little or no discomfort and are harmless and resolve on their own within a few weeks.

What Increases the Risk of Ovarian Cyst Rupture?

The functional and follicular ovarian cysts are a normal part of a woman's menstrual cycle, and they are harmless. Other ovarian cysts, such as endometriomas, dermoid cysts, and cystadenomas, are not normal. Some possible risk factors that cause the rupture of cysts are

  • Strenuous exercise.

  • Sexual intercourse.

  • Large cysts.

  • Previous history of ovarian cyst or ruptured ovarian cyst.

  • Abdominal trauma.

  • Anticoagulation drugs (medicines that help prevent blood clots).

What Are the Symptoms of Ruptured Ovarian Cysts?

A ruptured ovarian cyst can cause sudden pain in the pelvic area. The pain is usually sharp, mainly on the lower right side and at times on either side, continuing for a few days after rupture. The pain caused by an ovarian cyst mostly begins in the middle of the menstrual cycle, but the pain caused by the ruptured cyst can be experienced at other times of the menstrual cycle.

The symptoms of a ruptured ovarian cyst other than pain can include:

How Is a Ruptured Ovarian Cyst Diagnosed?

If the doctor suspects a ruptured cyst, additional tests may be needed for confirmation. Additional tests may include the following:

  • Pregnancy Test - To rule out if pregnancy is causing the cyst. If the patient is pregnant, less invasive treatments are chosen that do not cause any risk to the baby.

  • Blood Tests - These provide information on the iron levels and check for any signs of ovarian cancer.

  • Urine Test - It is essential to rule out urinary tract infections (UTI) and kidney stones.

  • CT Scan - This gives a more detailed picture of the pelvic organs.

  • Endocervical Swab - This test is used to rule out pelvic inflammatory disease.

  • Ultrasound of Abdomen - This is helpful to know the size and location of the cyst.

What Is the Treatment for a Ruptured Ovarian Cyst?

Rupture of an ovarian cyst can be managed in many ways:

  • By taking medicine.

  • By treating the symptoms.

  • Surgery.

An ovarian cyst may occur due to many reasons. Most ovarian cysts are harmless. But when a cyst ruptures, it can cause no symptoms or mild symptoms. The ruptured cysts causing mild symptoms can be managed with pain medicines.

In some cases, a ruptured cyst can cause severe symptoms like bleeding and severe pain in the lower belly, which requires immediate treatment. Hospitalization may be needed for severe cases, and IV (intravenous) pain medicines will be given through a needle inserted into the vein. In patients with severe internal bleeding, fluids or blood are replaced.

Surgery may be needed in very rare cases, and it may be an emergency surgery. During surgery, anesthesia is given to the patient. Then, a surgeon will make an incision in the abdomen; the bleeding is controlled, and any blood clots or fluids are removed, and the surgeon will remove the cyst or entire ovary, depending on the extent of the cyst.

Risks and possible complications of surgery for a ruptured ovarian cyst include:

  • Infection.

  • Bleeding.

  • Delayed healing.

  • Complications due to anesthesia.

  • Blood clot.

  • Damage to the nearby pelvic structures, blood vessels, and nerves.

  • Scar tissues that occur after the surgery.

Importance of Managing a Ruptured Cyst -In severe cases of ruptured ovarian cyst, excess blood loss can lead to less blood flow to the organs, and it can even lead to death in some rare cases.

What Is the Difference Between Complicated and Uncomplicated Ruptured Ovarian Cysts?

In Uncomplicated Ruptured Ovarian Cysts -

These cysts will be treated conservatively with pain medication and observation of the patient's symptoms. A functional ovarian cyst is an uncomplicated cyst.

In Complicated Ruptured Ovarian Cyst -

If the ruptured cyst has complications like heavy blood loss, the patient will be admitted to the hospital for observation, and the doctors will check for the following,

  • Monitor the vital signs and the ratio of the red blood cells to total blood volume.

  • Repeated scans are conducted in the peritoneal space (the space between the lining of the abdominal wall and the internal organs) to check for internal bleeding.

What Are the Complications of the Untreated Ruptured Ovarian Cyst?

In most cases, a ruptured ovarian cyst will not require any treatment and does not have complications. But when there is severe abdominal pain and other symptoms, it is better to consult a doctor and avoid complications.

The difficulties caused due to untreated ruptured ovarian cysts include,

  • If the cyst is bleeding, then there will be excessive blood loss.

  • If endometrioma is ruptured, it can cause excessive bleeding.

  • If there is an infection caused due to the rupture of the ovarian cyst, there is a danger of spreading. For example, a ruptured dermoid cyst can lead to inflammation of the perineum or peritonitis. If proper treatment is not provided, then it can become life-threatening.

  • A ruptured cyst can cause torsion or mimic the symptoms of ovarian torsion. Ovarian torsion occurs when blood supply to the ovaries is cut due to the twisting of the ovaries, this is an emergency and can lead to loss of ovary.

Conclusion:

Ruptured ovarian cysts are part of the normal menstrual cycle, and most of them dissolve on their own. But few ovarian cysts may be problematic if they rupture and cause serious symptoms. If there is severe pain, consult a doctor. Only drugs may be required in most cases, and in rare cases, surgery may be necessary.

Frequently Asked Questions


1.

What Are the Symptoms of a Ruptured Ovarian Cyst?

The ruptured ovarian cyst may cause mild discomfort in some, whereas others may feel the following symptoms:
Sudden onset of pain in the abdomen; the pain may last after a few days of the rupture.
- Nausea.
- Vomiting.
- Weakness.
- Vaginal bleeding.
- Tenderness in the abdominal area.
- Fever.
- Bloating.
- Fever.

2.

Does Ruptured Ovarian Cyst’s Pain Last Long?

The ovarian cyst is common among menstruating women, and it is harmless. These cysts may rupture every month and bleed during the menstrual cycle. However, if the size of the cyst is large, it may rupture and cause severe pain in the abdomen and pelvis. The pain is intense during the rupture of the ovarian cyst and followed by mild discomfort for a few days. The pain is usually relieved with over-the-counter pain medications. Consult a gynecologist if the pain lasts long.

3.

How Do I Know if an Ovarian Cyst Has Ruptured?

The ovarian cyst in women may rupture during the regular menstrual cycle and may not cause any symptoms. The ovarian cyst rupture may cause severe pain in the abdomen (lower right region), back, and pelvic area. The woman also experiences nausea, vomiting, and bloating during its rupture. Usually, it resolves on its own and may not require any treatment. But if the cyst is large, severe bleeding, dizziness, or weakness may occur after its rupture.

4.

What Causes a Ruptured Ovarian Cyst?

The types of ovarian cysts, namely the functional and follicular cysts, rupture during the regular menstrual cycle and are harmless. However, certain other ovarian cysts may rupture to cause severe pain and bleeding. The factors that increase the rupture of ovarian cyst are as follows:
- Strenuous physical exercise.
- Intercourse.
- Abdominal trauma.
- History of ovarian or ruptured ovarian cyst.
- Large cyst.

5.

Do Ruptured Ovarian Cyst Cause Complications?

A ruptured ovarian cyst does not require treatment, and it may resolve on its own. However, in certain conditions, it may lead to the following complications:
- Severe bleeding.
- Infection - Symptoms like fever and vomiting may indicate the infection of an ovarian cyst.
- If the cyst is large, it may cause the ovary to twist, and the blood flow is reduced; it is referred to as ovarian torsion. Surgery is essential in treating
ovarian torsion.

6.

When Does a Ruptured Ovarian Cyst Heal?

In many women, the ruptured ovarian cyst does not cause any harm and heals on its own within a few days. It may cause severe bleeding if the cyst is too large; medical attention is required to manage it. The cyst may heal in a few days after the treatment. In addition, the gynecologist may suggest surgery in rare cases, and after the surgical treatment, the complete recovery may occur after several weeks or months.

7.

What Is the Color of the Ovarian Cyst’s Discharge?

The ovarian cyst may generally rupture during the menstrual cycle. The factors like sexual intercourse, strenuous exercise, and cyst size may increase the risk of ovarian cyst rupture. It may also cause internal bleeding. During the menstrual cycle, the women’s natural secretion, along with the secretion of ruptured ovarian cyst, mixes to produce brown color discharge.

8.

How Do I Know the Side Effects of a Ruptured Ovarian Cyst?

The following symptoms indicate the side effects of a ruptured ovarian cyst:
- Sudden and severe abdominal pain.
- Nausea and vomiting.
- Fever with abdominal pain.
- Rapid breathing.
- Dizziness.
- Feeling cold.

9.

Does a CT Scan Show a Ruptured Ovarian Cyst?

Ovarian cysts are fluid-filled sac-like structures located within or on the surface of the ovaries. These cysts may usually rupture during the menstrual cycle, but some ruptured cysts may cause severe abdominal pain and bleeding. The gynecologist may suggest various tests to confirm the diagnosis. The computed tomography (CT) scan is preferred to diagnose abdominal and pelvic-related pain. The ruptured ovarian cyst may appear in a CT scan as multiple locules with thick walls; a fluid-filled pelvis is also observed.

10.

What Should I Do After an Ovarian Cyst Ruptures?

Even though the rupture of ovarian cysts is common, it is essential to do the following after its break:
- Look for indications like sudden abdominal pain, bleeding, dizziness, and vomiting. These symptoms require medical attention.
- Consult the gynecologist to know about the need for medications and surgical treatment.
- Limit physical activities after surgical treatment of ruptured ovarian cyst.
- Have a regular follow-up with the gynecologist to prevent complications.

11.

When Should I Visit an Emergency Department for an Ovarian Cyst?

A ruptured ovarian cyst may cause mild discomfort for a few days after menstruation. But, a few ruptured ovarian cysts with the following symptoms require a visit to the emergency department:
- Abdominal pain with vomiting and fever.
- Weakness or dizziness.
- Rapid breathing.
- Sudden and severe abdominal pain.
- Increased bleeding.

12.

Does Internal Bleeding Occur From a Ruptured Ovarian Cyst?

Yes, there are possibilities of internal bleeding from a ruptured ovarian cyst. It causes severe abdominal pain that worsens over time. The contents from the ruptured ovarian cyst may accumulate in the abdomen, causing bloating and severe abdominal pain. If the ruptured ovarian cyst is infected, it may worsen the condition. Increased blood loss may cause weakness and dizziness. Immediate medical attention is required in such situations.

Last reviewed at:
08 Sep 2022  -  5 min read

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