Presentation
Female patient presented with acute severe pelvic pain. History of surgical removal of left ovarian hemorrhagic cyst 4 months ago.
Patient Data
Uterus is anteverted with intact endometrial plate and IUD insitu. No focal lesions.
Enlarged left ovary showing well defined cystic lesion with irregular (collapsing) wall, low level echoes and fine internal septations. No calcifications or soft tissue nodules. Doppler scan (not shown) revealed no internal vascularity. It measures about 3 x 4 cm.
Normal size and echopattern of the right ovary with normal-sized follicles. No focal lesions.
Both ovaries are seen surrounded by mild amount of free fluid in the Douglas pouch with low-level debris (mostly denoting blood).
Minimal amount of free fluid seen in the Morrison pouch.
Case Discussion
Clinical data with the sonographic findings were highly suggestive of ruptured left ovarian hemorrhagic cyst with mild amount of hemoperitoneum.
Pregnancy test was done for exclusion of ectopic pregnancy and it was negative.
Conservative symptomatic treatment was advised and follow up ultrasound was recommended.
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