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Ovarian cysts are fluid filled cavities formed on the surface of the ovaries. Although such cysts are formed in the ovaries among most women in the child bearing age group, not all will feel any symptoms as they usually get settled by themselves.



However, the cysts which can give rise to symptoms are usually large and could have burst due to various reasons.

What makes burst ovarian cysts cause symptoms?

Although bursting of cysts occur in the ovary during the ovulation process in which an egg gets released into the fallopian tube, these bursts are fairly regulated and do not cause serious leakage to give rise to any symptoms. When a larger cyst bursts, the leakage may be more significant and
could irritate the surrounding tissues as well as the peritoneal cavity. This could be even more significant when the leaked fluid contains more blood. At the same time, the site of bleeding, the volume, presence of other tissues as well as the potential for infection could also determine the probable symptoms.

What are the symptoms commonly associated with burst ovaries?

Among the most common symptoms associated with a burst ovarian cyst is the presence of lower abdominal pain and in most instances, it can be severe, and could occur rather suddenly.

In some instances, the maximum pain could be felt on either side of the lower abdomen and could also be radiating into the lower limbs or to the back. In some instances, the pain could also be felt on the shoulder tip as heavy leakage could irritate the diaphragm between the chest and the abdominal cavity.

Certain patients can also associate the pain with sexual intercourse and to the onset of menstruation.

Nausea and vomiting could also be associated with a burst ovary and so is the presence of abdominal distension. Such patients may also complain of an inability to pass urine and sometimes vaginal bleeding which can most often be self limiting.

How can a diagnosis of a burst ovarian cyst be made?

When any of these symptoms manifest even with minimum discomfort it should be investigated further as a burst ovarian cyst can lead to complications which can sometimes be fatal. However, the sudden onset severe pain could most likely compel a person to seek emergency medical attention without even knowing what goes on inside.

Following arriving at the emergency department, investigations will be carried out in order to recognize the underlying cause and in case there is a cyst or a ruptured cyst, the amount of bleeding, the natureof the cyst and other possible complications will be noted.

Ultrasound and x-ray imaging of the abdomen and the pelvis as well as blood tests should be carried out. Based on the history, examination and the investigation findings, the modality of treatment will be determined.

What are the treatment options for a burst ovarian cyst?

The initial treatment will focus on stabilizing the patient by introducing an intravenous line, injecting antibiotics in case of a possible infection, infusing saline or sometimes blood which is rarely needed. At the same time, pain relievers should also be given to alleviate the discomfort associated with the condition.

Once the patient is stabilized, management proper will start. This would require aspirating the leaked fluid into the peritoneal cavity in case the fluid amount is more than a certain volume.

In case a ruptured cyst could give rise to further complications and if there is a possibility of residues in the peritoneal cavity, there may be a need to surgically access the cavity and the pelvis through a laparoscopic technique. In such instances it will be possible to remove, clean and suture without having to open the abdomen.

Following this the patient may have to be put on antibiotics to prevent the possibility of infections and in most instances, the choice of antibiotic would be intravenous.

After the treatment process, such women may need to be on oral contraceptive pills or other modalities of treatment to make the menstruation regular and reduce the possibility of a recurrence.

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