An ovarian cyst usually only causes symptoms if it ruptures

Aetiology

• Commonly occur in functional cysts
• May also occur dermoid or endometrioma
• Rupture can be spontaneous or after trauma (SI, contact sports)

Clinical features

Symptoms

• Most common cause of acute pelvic pain in an afebrile, premenopausal women

Signs

• May be rebound tenderness
• Haemorrhage from a cyst can (rarely) be severe enough to cause shock

Investigations

• Ultrasound: shows whether rupture has occurred and whether the cyst is haemorrhagic

Management

• Treated conservatively in a premenopausal woman unless evidence of hypovolaemic shock
• A haemorrhagic cyst or ruptured cyst in a postmenopausal woman deserves surgical evaluation