A ruptured ovarian cyst is a common phenomenon, with presentation ranging from no symptoms to symptoms mimicking an acute abdomen.
Sequelae vary. Menstruating women have rupture of a follicular cyst every cycle, which is either asymptomatic or with mild transient pain (mittelschmerz). In less usual circumstances, the rupture can be associated with significant pain. In very rare circumstances, intraperitoneal hemorrhage
and death may occur.
The most pressing issues facing clinicians encountering patients with potential cyst rupture in the acute setting are to rule out ectopic pregnancy, ensure adequate pain control, and rapidly assess the patient for hemodynamic instability to allow appropriate triage. Although most patients require only observation, some need analgesics for pain control and laparoscopy or laparotomy for diagnosis or to achieve hemostasis.
While some hemorrhage associated with ovarian cyst rupture has unclear etiology, there are recognized risk factors. These include abdominal trauma and anticoagulation therapy.
The condition most commonly occurs in reproductive-aged women of 18-35 years.
See also the Medscape Reference article Ovarian Cysts.