Ovarian cyst rupture

The most serious complication of neoplasms of the genital area is the rupture of the ovarian cyst - a pathological condition in which the entire contents of cystic education fills the peritoneum.

The process is dangerous for the possibility of developing peritonitis, which threatens the patient's life. This fact, in turn, requires an immediate appeal to a specialist with the slightest suspicion of breaking cystic education.

[1], [2]

Causes of rupture of ovarian cysts

From the appearance of cystic education, unfortunately, not a single woman is insured. Formation and self-resolution of the functional form of the tumor often occurs asymptomatically. But not all cysts are inclined to regress.

The processes of active growth of neoplasm with increasing liquid content are dangerous with the possibility of overstretching and loss of the integrity of the capsule.

There are following causes of rupture of the ovarian cyst: 

• inflammatory diseases of the ovaries, which caused thinning of the follicular wall; 
• hormonal imbalance; 
• bleeding disorders; 
• excessive physical activity (lifting weights, etc.); 
• frequency and activity in sex.

[3]

Symptoms of rupture of ovarian cysts

The symptomatology of the "acute abdomen" indicates a twisting of the tumor's foot or a rupture of the formation. Sharp tenderness in the abdomen, an increase in body temperature to 39 ° C, vomiting, and muscular tension of the peritoneum may serve as an excuse for emergency surgical intervention.

Typical symptoms of ruptured ovarian cysts, indicating a violation of the integrity of education: 

• temperature, not knocked down by antipyretic agents; 
• piercing, growing pain syndrome, as a dagger, mostly in the abdomen; 
• feeling of weakness, general unstable condition; 
• vaginal discharge of unusual character; 
• uterine bleeding; 
• severe intoxication with nausea or vomiting; 
• blanching of the skin; 
• pre-fainting / syncope; 
• changes in stool, problems with defecation and gas removal; 
• decrease in pressure.

As a rule, rupture of the ovarian cyst does not entail dysfunction of the vital organs of the peritoneum. In patients with a strong pain syndrome, a moderate tachycardia of a permanent character is observed, which is not a cause for concern. When a blood test can show a decrease in hemoglobin.

Disturbing symptoms of a ruptured ovarian cyst that talk about internal bleeding include: 

• tachycardia of a growing species; 
• blood pressure jumps; 
• orthostatic disorders.

Pain after rupture of the ovarian cyst

The collection of anamnesis with rupture of the ovarian cyst indicates that the nature and intensity of the pain syndrome differ significantly and depend on: 

• a type of cystic education; 
• day of the menstrual cycle, in which a break occurred; 
• physical activity of the patient.

For example, the rupture of the ovarian cyst of the dermoid type is accompanied by painful, acute pain. The onset of ovulation (mid-monthly cycle) occurs with a moderate pain associated with the release of the ovule from the burst follicle, which is a follicular cyst.

The rupture of any type of tumor is described by sudden pain sensations, localized mainly on one side of the abdomen. Quite often, the pain associated with rupturing the ovarian cysts covers the upper abdomen, so women complain of the soreness of the entire abdominal area.

To provoke pain syndrome and rupture of the tumor wall are capable of physical exercises, sexual intercourse, traumas (at impact, fall, as a result of surgery, etc.). Often the pain increases during movement, which is a sign of irritation of the peritoneum. Pain syndrome often involves loss of consciousness, which facilitates the diagnosis.

Before the break, there may be lumbar pains or discomfort in the pelvic zone of a pulling character, a feeling of heaviness.

Rupture of the cyst of the yellow body

The rupture of the cyst of the yellow body is a rare phenomenon, as the cystic formation has a thick capsule. The loss of the integrity of the membrane is accompanied by a sharp, piercing lower abdominal pain, which causes the patient to "fold in two." And the temperature can remain normal, with obvious signs of intoxication, severe weakness, the presence of cold sweat, fainting.

If a ruptured cyst of the yellow body occurs in the vasculature of the ovary, bleeding into the peritoneum and pelvic organs may occur. Such a sudden filling of the ovary with blood in the peritoneal and pelvic region is called apoplexy of the ovary. The condition of a woman will vary from mild weakness, drowsiness to a state of stupor and shock depending on the volume of lost blood.

Apoplexy against a background of rapid growth of cystic education can be triggered by a rapid change in the position of the body (jumps, somersaults, etc.), stroke, sudden movements, active sexual intercourse.

The presence of intra-abdominal bleeding is determined by the factors: pallor of the skin and mucous membranes, increased heartbeats and a decrease in pressure.

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

Rupture of the follicular ovarian cyst

The follicular type of cyst is a neoplasm capable of self-extinction when the hormonal background is stabilized by taking hormonal contraceptives.

Dagger pain syndrome indicates the rupture of the follicular ovarian cyst, which occurs with severe symptoms of intoxication and normal body temperature.

The risk of violation of the integrity of the capsule of actively expanding cystic education is especially great in case of physical exertion, sexual intercourse, during gestation.

Symptoms of rupture of cystic neoplasm include: 

• weak, fainting, dizziness; 
• lowering blood pressure; 
• the urge to vomit; 
• clinic "acute abdomen" - a dagger-like kind of pain in the lower abdomen, leading to the development of shock; 
• cyanosis (blueing) or pallor of the skin.

A rupture of the ovarian follicular cyst can occur against the background of intra-abdominal hemorrhage, which is characterized by a retarded, weak condition, frequent palpitation at low pressure, shock.

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

Rupture of functional ovarian cyst

Recall that every month a healthy woman develops a natural cyst in one of the ovaries, which is called the dominant follicle or the Earl's follicle. When ovulation, the follicle bursts, releasing the egg, ready to fertilize in the fallopian tube. The dominant follicle forms into the yellow body, which serves to maintain the hormonal balance in the bearing of the child.

In some cases, for reasons unknown to medicine, the Earl's follicle does not burst, but continues to increase in volume due to accumulation of fluid in it. So there is a follicular (retention) cyst, less often the cyst of the yellow body, which is classified as functional (physiological type) tumors.

Rupture of functional ovarian cysts occurs suddenly with acute pain in the lower abdomen with weakness, dizziness, pallor of skin, sometimes bloody discharges from the vagina, not related to menstruation.

The greatest danger is the bleeding into the peritoneal zone, therefore at the first signs of a ruptured cyst, emergency medical attention should be called for.

Rupture of the endometrioid cyst

Endometrioid cysts are surgically removed because of the high probability of rupture of the cystic capsule, the possibility of transformation into malignant formation.

A tumor of this type is predominantly located in the vicinity of large vessels feeding the ovary. Endometrioid formation on the ovary is not single, often the foci of endometriosis appear on the surface of the peritoneum, bladder and other organs.

Spontaneous rupture of the endometrioid cyst with spilling of the contents into the peritoneum is dangerous by the development of the intestinal paresis, the adhesion process.

Perforation of the tumor is characterized by a strong, paroxysmal painful lower abdominal syndrome accompanied by nausea, vomiting. Possible loss of consciousness. Weakened intestinal peristalsis, bloating. The patient's body temperature may correspond to the norm.

Cyst rupture during pregnancy

According to statistical data, cystic neoplasms, developing along with pregnancy, are quite common. The greatest caution is caused by large cysts with a diameter of up to 8 cm, requiring surgical intervention. Most often, tumors are removed by laparoscopy at the fourteenth to sixteenth week of gestation, if the formation continues to grow rapidly, which is confirmed by an ultrasound examination. Cases with particularly large cysts may require laparotomy.

Such pathological conditions as: torsion and rupture of the cyst during pregnancy lead to bleeding, acute pain, can provoke premature labor or miscarriage. For this reason, doctors recommend surgery with the growth of cystic education.

The risk group includes pregnant women with two types of cysts: 

1. cystadenoma (filled with liquid or mucus), reaching 12 cm in diameter and characterized by a painful pain syndrome of permanent appearance; 
2. endometrioid or "chocolate" - consists of a brown, bloody substance resembling chocolate. As a consequence of endometriosis, such a tumor forms with hormonal imbalance. When it ruptures, blood is filled in the abdominal cavity.

The described types of tumors are subject to mandatory removal, despite the timing of pregnancy.

[4], [5]

Consequences of rupture of the ovarian cyst

The loss of the integrity of the wall of cystic education always entails a number of factors that are unfavorable for the patient's health: 

• anemia (due to extensive loss of blood develops anemia); 
• lethal outcome, with untimely referral to medical personnel; 
• Adhesive process 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 washing the abdominal cavity and repeated operation.

In especially severe cases, the consequences of rupturing ovarian cysts lead to the complete removal of the affected ovary, which becomes a problem for conception.

[6], [7]

Treatment of ruptured ovarian cysts

For the purpose of diagnosing the rupture of cystic ovarian formation the following research methods are used: 

• Ultrasound; 
• method of puncture - puncture the peritoneal wall through the vagina by means of a special needle; 
• laparoscopy - the study of the ovary due to a special camera (the image is displayed on the monitor), introduced through the incision into the peritoneum zone.

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. The hospital establishes an accurate diagnosis, classifies the degree of hemorrhage, on the basis of which an individual treatment and rehabilitation program is selected.

Treatment of rupture of the ovarian cyst of a mild form is performed by conservative methods, with the help of pharmacological preparations. In the presence of complications, surgical intervention (laparoscopy) may be necessary, during which the follicle is dissected, as well as the ovary partially or completely.

With the purpose of deducing a patient from the state of hypovolemic shock, infusion of solutions is used, and to restore homeostasis, an emergency laparotomy intervention.

In parallel, they are prescribed anti-inflammatory therapy, physiotherapy (to prevent adhesions), hormones are individually selected. With abundant blood loss, hemostatic therapy, blood transfusion.

Operation with rupture of the ovarian cyst

Abundant blood loss with rupture of the ovarian cyst is an occasion for surgical intervention. The most common method is considered to be laparoscopy. During surgical manipulation, it is possible to stop bleeding. The injured follicle and part of the ovary are excised. Sometimes you have to remove the entire ovary. If bleeding is not a threat, then the improvement of the state is achieved by bed rest and cold compresses on the stomach.

Laparoscopy is an operation when the ovarian cyst ruptures, at which three holes (near the navel) are made on the wall of the peritoneum to insert a camera with illumination and surgical instruments. In this case, a general anesthetic is used. The abdominal cavity is filled with a special gas to "inflate" the abdomen and move the intestine for unobstructed penetration to the ovary.

The procedure is considered to be less traumatic and most effective. However, as a result of difficult visibility, injuries of nearby organs, lesions of the vessels of the puncture zone, and postoperative bleeding are possible.

Prevention of rupture of the ovarian cyst

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

• visit the gynecologist at least once every six months; 
• during time to differentiate and cure the inflammatory processes of the genitourinary sphere; 
• strictly follow the medical prescriptions, prohibitions and recommendations concerning physical overstrain or sexual contacts.

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

Forecast of rupture of ovarian cyst

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

The rupture of the ovarian cyst is best prevented by following the recommendations of the treating doctor, sleeping and eating habits, without abusing physical exertion.

[8]