Hemorrhagic ovarian cyst
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28 year old female, 4/52's pregnant, presents with infrapubic mass and tender RIF. WCC is 17.8.
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The left ovary is enlarged measuring 12 x 8 cm. Within it is a large hypoechoic cyst measuring 12 x 7.8 cm with a weblike septa and would be in keeping with a large hemorrhagic cyst. Free fluid demonstrated adjacent to it and within the pelvis. The right ovary measures 1.7 x 2 x 2 cm and is normal. Intrauterine pregnancy demonstrated with a CRL measuring 2.7 mm in keeping with gestational age of 5 weeks 4 days (compared to LMP GA 7 weeks 0 days) and therefore revised gestational age is 5 weeks 4 days. Fetal heart rate of 127 bpm noted and therefore pregnancy viable. No evidence of enlarged appendix is identified. Patient was noted to be non tender in the right iliac fossa. The right kidney measures 11.5 cm. The left kidney measures 11.8 cm. No evidence of hydronephrosis or calcification.
- Large left hemorrhage cyst present likely cause of patient's symptoms. No appendix identified but patient not tender in right iliac fossa.
- Viable pregnancy. Revised dates due to discordance between CRL and LMP with new gestational age of 5 weeks 4 days.
Acknowledgement: Dr Rafal Grabinski
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