• Clinical science

Ovarian cyst


  • Definition: fluid-filled sacs within the ovary that result from a disruption in the development of follicles or corpus luteum
  • Types
  • Clinical features: most often asymptomatic unless complications occur
  • Diagnosis: Pelvic ultrasound
    • Smooth lining on all sides
    • Single or multiple
    • Hypoechoic to anechoic
    • Fluid-level
  • Complications
  • Treatment: Usually no treatment is needed, as cysts are asymptomatic (in absence of complications).


Ovarian torsion

  • Etiology
    • Physical activity (e.g., when exercising)
    • The primary risk factor is ovarian enlargement (e.g., pregnancy, tumors, cysts).
  • Clinical features
    • Sudden onset unilateral lower abdominal pain
    • Nausea
    • Vomiting
  • Diagnosis: Pelvic ultrasound with Doppler velocimetry shows enlarged, edematous ovaries with decreased blood flow.
  • Treatment: Detorsion via laparoscopic surgery is recommended for viable ovaries.


Ruptured ovarian cyst

  • Etiology: Physical activity (e.g., when exercising)
  • Clinical features
    • Sudden onset unilateral lower abdominal pain
    • In case of a very large cyst: Fluid and blood loss may cause acute abdomen and shock.
  • Diagnosis: Pelvic ultrasound shows free fluid, most commonly in the pouch of Douglas (rectouterine pouch).
  • Treatment
    • Hemodynamically stable patients can be observed and given analgesics.
    • Hemodynamically unstable patients require laparoscopy to control hemorrhaging.


last updated 02/25/2019
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