An unexpectedly therapeutic ultrasound: real-time capture of ovarian cyst rupture

Simple ovarian cysts and cyst accidents are common gynaecological presentations in pre-menopausal women. In this case report, a cyst rupture occurred during ultrasound scan, neatly uniting the pre- and post-accident appearances in one event.

The patient attended with pain and a 6cm cyst seen on CT, for ultrasound evaluation and follow-up by gynaecology as a day attender. At ultrasound scan the left ovarian cyst was immediately evident, but rapidly ruptured, devolved and disappeared, leaving only a normal left ovary and some surrounding free liquid. Time-stamped images show the evolution from tense cyst through regressing cyst walls and finally the post-rupture outcome, all within a few minutes. They also allow us to compare the volume of the cyst (100mL) with the volume of evident free liquid post rupture (20mL) as a learning point for suspecting recent cyst rupture at otherwise normal pelvic ultrasound.

Although the presentation and regression of the cyst are commonplace occurrences, it is highly unusual to capture this event in real-time ultrasound scanning. This case report may therefore be of interest to those who are involved with ultrasound in gynaecology

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