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Ovarian cyst
From WikEM
Contents
Background
- Most common are functional or follicular cysts
- Less common include PCOS, cystadenomas, and dermoid cysts
- Cysts are generally >1cm in size
- Cysts are at risk of torsion when >4cm
- Cysts <2cm are virtually risk free from torsion
Clinical Features
- Most tend to be asymptomatic
- Can cause:
- Dull pelvic pain or fullness
- Dyspaneuria
- Pressure on the bladder
- They can be significantly painful if ruptured
- If there is bleeding into the cyst and it ruptures, it can be life threatening
Differential Diagnosis
Right
RLQ Pain
- Appendicitis
- Abdominal aortic aneurysm
- Crohn's disease (terminal ileitis)
- Diverticulitis (cecal, Asian patients)
- Ectopic
- Endometriosis
- Epiploic appendagitis
- Herpes zoster
- Inguinal hernia
- Ischemic colitis
- Meckel's diverticulum
- Mesenteric lymphadenitis
- Mittelschmerz
- Ovarian cyst
- Ovarian torsion
- PID
- Psoas abscess
- Testicular torsion
- Kidney stone
- Neutropenic enterocolitis (typhlitis)
Left
LLQ Pain
- Diverticulitis
- Kidney stone
- UTI
- Pyelonephritis
- Ectopic Pregnancy
- Infectious colitis
- Inflammatory bowel disease (Crohn's Disease, Ulcerative Colitis)
- Inguinal Hernia
- Mesenteric Ischemia
- Epiploic appendagitis
- Mittelschmerz
- Ovarian cyst
- Ovarian torsion
- PID
- Psoas abscess
- Testicular torsion
- Appendicitis
- Abdominal aortic aneurysm
- Herpes zoster
- Endometriosis
- Colon cancer
- Irritable bowel syndrome
- Small bowel obstruction
Workup
- Bimanual exam
- Adenexal mass
- Adenexal tenderness
- Ultrasound
- Absence of cyst may suggest rupture
Management
- NSAIDs
- Oral contraceptives
- No benefit has been found though Gyn may suggest them[1]
Disposition
- Home
- Follow up with OBGyn
See Also
External Links
References
- ↑ Cochrane Database Syst Rev 2011. Sep 7;(9):CD006134.
