HomeAnswersObstetrics and Gynecologyovarian cystsDoes emergency surgery necessary for ruptured ovarian cyst?

I am having pain due to ruptured ovarian cyst. Does it need an emergency surgery?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Sameer Kumar

Medically reviewed by

iCliniq medical review team

Published At December 7, 2019
Reviewed AtAugust 24, 2023

Patient's Query

Hello doctor,

I was seen over the weekend at the ER. They did a CT scan and saw an ovarian cyst that they believed wrapped around the ovary and ruptured. They also saw liquid in the uterus. I have only one ovary as this has happened before years ago. They thought it was an emergency and were prepared to do emergency surgery, but they did an ultrasound both normal and pelvic to be sure. I ended up not needing emergency surgery and was sent home. I called the next day to try to visit a gynecologist for this as I am in all sorts of pain. Since I am not an established patient, they are waiting for a cancellation to get me in, as they are currently booked till two more months. UntiI this I cannot wait. I am in so much pain it is unreal. Medically speaking is this an emergency? Should I go back to the ER? I am currently taking Norco, Tramadol, and prescribed anti-nauseous medicine.

Answered by Dr. Sameer Kumar

Hello,

Welcome to icliniq.com.

The fact that there is a large ovarian cyst which has invariably made the ovary bulky and the presence of acute onset of pain in the lower abdomen which if waxing and waning type may indicate a possible torsion of the ovary which is common in the presence of large cysts and is definitely an emergency. It would be better to rule it out with a doppler study first in which tortious blood flow may be evident. It is always better to consider ovarian torsion and deal with it first as the rest of the concerns can be managed symptomatically but not torsion which can cause acute loss of blood supply to the only ovary now and can cause damage and gangrene later. So it would be best if you would report to the ER asap.

The Probable causes

Torsion ovary, acute PID (pelvic inflammatory disease), acute cyst rupture.

Investigations to be done

Doppler USG (ultrasound) urgent or laparoscopy.

Differential diagnosis

Acute PID (pelvic inflammatory disease), Torsion ovary.

Probable diagnosis

Ovarian torsion.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Sameer Kumar
Dr. Sameer Kumar

Obstetrics and Gynecology

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