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

Answered by
Dr. Sameer Kumar
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 06, 2019

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.

Dr. Sameer Kumar

Infertility Obstetrics And Gynaecology


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.

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