A ruptured ovarian cyst

The most severe complication of neoplasms of the genital area is considered to be the rupture of an ovarian cyst - this is a pathological condition in which the entire contents of the cystic formation fill the peritoneal area.

The process is dangerous due to the possibility of developing peritonitis, which threatens the patient's life. This fact, in turn, requires immediate referral to a specialist at the slightest suspicion of a rupture of a cystic formation.

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Causes of ovarian cyst rupture

Unfortunately, no woman is immune from the appearance of a cystic formation. The formation and independent resorption of a functional type of tumor often occurs asymptomatically. But not all cysts are prone to regression.

The processes of active growth of a neoplasm with an increase in liquid contents are dangerous due to the possibility of overstretching and loss of integrity of the capsule.

The following reasons for ovarian cyst rupture are identified:

• inflammatory diseases of the ovaries, resulting in thinning of the follicular wall;
• hormonal imbalance;
• blood clotting disorders;
• excessive physical exertion (lifting weights, etc.);
• frequency and activity in sex.

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Symptoms of a ruptured ovarian cyst

The symptoms of "acute abdomen" indicate torsion of the tumor stalk or rupture of the formation. Sharp pain in the abdomen, an increase in body temperature to 39C, vomiting, and muscle tension of the peritoneum may serve as a reason for emergency surgical intervention.

Typical symptoms of ovarian cyst rupture, indicating a violation of the integrity of the formation:

• temperature that cannot be reduced by antipyretic drugs;
• piercing, increasing pain syndrome, like a dagger strike, mainly in the lower abdomen;
• feeling of weakness, general instability;
• vaginal discharge of an unusual nature;
• uterine bleeding;
• severe intoxication with nausea or vomiting;
• paleness of the skin;
• pre-syncope/fainting state;
• changes in stool, problems with defecation and gas removal;
• pressure reduction.

As a rule, ovarian cyst rupture does not entail dysfunction of the vital organs of the peritoneum. Patients experience moderate tachycardia of a constant nature due to severe pain syndrome, which is not a cause for concern. A blood test may reveal a decrease in hemoglobin levels.

Warning signs of a ruptured ovarian cyst that indicate internal bleeding include:

• tachycardia of increasing type;
• blood pressure surges;
• orthostatic disorders.

Pain from ruptured ovarian cyst

Anamnesis collection in case of ovarian cyst rupture indicates that the nature and intensity of pain syndrome vary significantly and depend on:

• type of cystic formation;
• the day of the menstrual cycle on which the rupture occurred;
• physical activity of the patient.

For example, a ruptured dermoid ovarian cyst is accompanied by excruciating, acute pain. The onset of ovulation (the middle of the monthly cycle) occurs with moderate pain associated with the release of the egg from the ruptured follicle, which is a follicular cyst.

Rupture of any type of tumor is described by sudden pain sensations, localized mainly on one side of the lower abdomen. Quite often, pain from a ruptured ovarian cyst affects the upper abdomen, so women complain of pain in the entire abdominal area.

Physical exercise, sexual intercourse, injuries (from a blow, a fall, as a result of surgery, etc.) can provoke pain syndrome and rupture of the tumor wall. Often the pain increases during movement, which is a sign of peritoneal irritation. The pain syndrome is often followed by loss of consciousness, which facilitates diagnosis.

Before the rupture, there may be lumbar pain or discomfort in the pelvic area of a pulling nature, a feeling of heaviness.

Rupture of the corpus luteum cyst

Rupture of a corpus luteum cyst is a rare occurrence, since the cystic formation has a thick capsule. The loss of the integrity of the membrane is accompanied by acute, piercing pain in the lower abdomen, forcing the patient to "fold in half". Moreover, the temperature may remain normal, with obvious signs of intoxication, severe weakness, cold sweat, and fainting.

If the rupture of the corpus luteum cyst occurs in the vascular zone of the ovary, bleeding into the peritoneum and pelvic organs is possible. Such sudden filling of the ovary with blood with blood entering the peritoneum and pelvic area is called ovarian apoplexy. The woman's condition will vary from mild weakness, drowsiness to a state of stupor and shock, depending on the volume of blood lost.

Apoplexy against the background of rapid growth of a cystic formation can be provoked by a rapid change in body position (jumping, somersaulting, etc.), a blow, sudden movements, or active sexual intercourse.

The presence of intra-abdominal bleeding is determined by the following factors: pallor of the skin and mucous membranes, increased heart rate and decreased blood pressure.

The choice of treatment method (conservative/surgical) in this case is influenced by: the abundance and degree of bleeding, the blood's ability to clot, and the woman's general well-being.

Rupture of ovarian follicular cyst

A follicular cyst is a neoplasm that can disappear on its own when hormonal levels are stabilized by taking hormonal contraceptives.

Stabbing pain syndrome indicates a rupture of a follicular ovarian cyst, which occurs with pronounced symptoms of intoxication and normal body temperature.

The risk of damage to the integrity of the capsule of an actively growing cystic formation is especially high during physical exertion, sexual intercourse, and during pregnancy.

Symptoms of a ruptured cystic neoplasm include:

• weakness, fainting, dizziness;
• lowering blood pressure;
• urge to vomit;
• "acute abdomen" clinic - dagger-like pain in the lower abdomen, leading to the development of shock;
• cyanosis (blue discoloration) or paleness of the skin.

Rupture of a follicular ovarian cyst can occur against the background of intra-abdominal hemorrhage, which is characterized by a lethargic, weak state, rapid heartbeat with low blood pressure, and shock.

Violation of the integrity of the cystic capsule is a critical condition for the patient, often leading to purulent peritonitis, severe blood loss, anemia, the development of adhesions and the inability to experience the joy of motherhood.

Rupture of a functional ovarian cyst

Let's remember that every month every healthy woman develops a natural cyst in one of her ovaries, which is called the dominant follicle or Graf's follicle. During ovulation, the follicle bursts, releasing an egg ready to be fertilized in the fallopian tube. The dominant follicle develops into the corpus luteum, which serves to maintain hormonal balance during pregnancy.

In some cases, for reasons unknown to medicine, the Graf follicle does not burst, but continues to increase in volume due to the accumulation of fluid in it. This is how a follicular (retention) cyst appears, less often a corpus luteum cyst, which are classified as functional (physiological type) tumors.

Rupture of a functional ovarian cyst occurs suddenly with acute pain in the lower abdomen, accompanied by weakness, dizziness, pale skin, and sometimes with bloody vaginal discharge not associated with menstruation.

The greatest danger is bleeding into the peritoneum, so at the first signs of a cyst rupture, you should call for emergency medical care.

Rupture of endometrioid cyst

Endometrioid cysts are removed surgically due to the high probability of rupture of the cystic capsule and the possibility of transformation into a malignant tumor.

This type of tumor is predominantly located near large vessels that feed the ovary. An endometrioid formation on the ovary is not isolated; foci of endometriosis are often detected on the surface of the peritoneum, bladder, and other organs.

Spontaneous rupture of an endometrioid cyst with the release of contents into the peritoneum is dangerous due to the development of intestinal paresis and adhesions.

Tumor perforation is characterized by severe, paroxysmal pain in the lower abdomen accompanied by nausea and vomiting. Loss of consciousness is possible. Weakened intestinal peristalsis and bloating are also noted. The patient's body temperature may be normal.

Rupture of a cyst during pregnancy

According to statistics, cystic neoplasms that develop during pregnancy are quite common. The greatest concern is caused by large cysts up to 8 cm in diameter, which require surgical intervention. Most often, tumors are removed by laparoscopy in the fourteenth to sixteenth week of gestation, if the formation continues to grow rapidly, which is confirmed by ultrasound examination. Cases with particularly large cysts may require laparotomy.

Such pathological conditions as: torsion and rupture of a cyst during pregnancy entail bleeding, acute pain, and can provoke premature labor or miscarriage. For this reason, doctors recommend surgery when the cystic formation grows.

Pregnant women with two types of cysts are at risk:

1. cystadenoma (filled with fluid or mucus), reaching 12 cm in diameter and characterized by excruciating pain of a constant nature;
2. endometrioid or "chocolate" - consists of a brown, bloody substance resembling chocolate. Being a consequence of endometriosis, such a tumor is formed due to hormonal imbalance. When it ruptures, the abdominal cavity is filled with blood.

The described types of tumors must be removed, regardless of the duration of pregnancy.

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Consequences of ovarian cyst rupture

Loss of integrity of the wall of a cystic formation always entails a number of factors that are unfavorable for the patient’s health:

• anemia (due to extensive blood loss, anemia develops);
• fatal outcome if medical attention is not sought in a timely manner;
• adhesions as a result of surgical intervention, leading to infertility and increasing the risk of pregnancy outside the uterine cavity;
• the phenomenon of purulent peritonitis, which often requires lavage of the abdominal cavity and repeated surgery.

In particularly severe cases, the consequences of a ruptured ovarian cyst lead to the complete removal of the affected ovary, which becomes a problem for conception.

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Treatment of ovarian cyst rupture

To diagnose a ruptured ovarian cyst, the following research methods are used:

• ultrasound;
• puncture method – puncturing the peritoneal wall through the vagina using a special needle;
• laparoscopy – examination of the condition of the ovary using a special camera (the image is displayed on the monitor) inserted through an incision into the peritoneum.

If there is the slightest suspicion of a cyst rupture, even in the absence of bleeding (it is often delayed), the woman should be immediately taken to the hospital. In the hospital, an accurate diagnosis is made, the degree of blood loss is classified, on the basis of which an individual treatment and rehabilitation program is selected.

Treatment of mild ovarian cyst rupture is carried out by conservative methods, using pharmacological drugs. In the presence of complications, surgical intervention (laparoscopy) may be required, during which the follicle is excised, as well as the ovary, partially or completely.

In order to bring the patient out of the state of hypovolemic shock, infusion of solutions is used, and to restore homeostasis, emergency laparotomy is used.

In parallel, anti-inflammatory therapy, physiotherapy (to prevent adhesions) are prescribed, and hormonal drugs are selected individually. In case of profuse blood loss, hemostatic therapy and blood transfusion are included.

Surgery for ruptured ovarian cyst

Heavy bleeding from a ruptured ovarian cyst is a reason for surgical intervention. The most common method is laparoscopy. During the surgical manipulation, it is possible to stop the bleeding. The damaged follicle and part of the ovary are cut out. Sometimes it is necessary to remove the entire ovary. If the bleeding does not pose a threat, then the condition is improved by bed rest and cold compresses on the abdomen.

Laparoscopy is an operation for ruptured ovarian cysts, in which three holes are made in the abdominal wall (near the navel) to insert a camera with illumination and surgical instruments. In this case, general anesthesia is used. The abdominal cavity is filled with a special gas to "inflate" the abdomen and move the intestines for unimpeded access to the ovary.

The procedure is considered to be minimally invasive and the most effective. However, due to obstructed visibility, injuries to nearby organs, damage to the vessels of the puncture area, and postoperative bleeding are possible.

Prevention of ovarian cyst rupture

It is easier to prevent any pathological condition than to treat it later. Therefore, women with neoplasms should follow a number of rules:

• visit a gynecologist at least once every six months;
• to differentiate and treat inflammatory processes of the genitourinary system in time;
• strictly follow medical prescriptions, prohibitions and recommendations regarding physical overexertion or sexual contact.

Prevention of ovarian cyst rupture also includes timely removal of the cystic formation and planning of conception.

Prognosis of ovarian cyst rupture

With timely treatment, the prognosis for ovarian cyst rupture is favorable for life. After partial resection of the ovary or its complete removal, the woman's reproductive function is preserved, since the egg matures in a healthy ovary.

It is better to prevent ovarian cyst rupture by following the recommendations of your doctor, sleep and diet, and not overdoing physical activity.

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