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
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Strenuous exercise.
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Sexual intercourse.
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Large cysts.
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Previous history of ovarian cyst or ruptured ovarian cyst.
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Abdominal trauma.
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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:
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Nausea.
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Vomiting.
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Bleeding from the vagina.
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Tenderness in the abdomen.
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Fever with abdominal pain.
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Dizziness.
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Pressure in the pelvic region.
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Weakness or lightheadedness.
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Frequent urination.
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Bloating.
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Referred shoulder pain.
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Breathing at a rapid rate.
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Chilly, clammy skin.
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:
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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.
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Blood Tests - These provide information on the iron levels and check for any signs of ovarian cancer.
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Urine Test - It is essential to rule out urinary tract infections (UTI) and kidney stones.
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CT Scan - This gives a more detailed picture of the pelvic organs.
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Endocervical Swab - This test is used to rule out pelvic inflammatory disease.
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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:
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By taking medicine.
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By treating the symptoms.
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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:
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Infection.
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Bleeding.
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Delayed healing.
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Blood clot.
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Damage to the nearby pelvic structures, blood vessels, and nerves.
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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,
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Monitor the vital signs and the ratio of the red blood cells to total blood volume.
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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,
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If the cyst is bleeding, then there will be excessive blood loss.
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If endometrioma is ruptured, it can cause excessive bleeding.
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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.
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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.
