Ovarian Cyst Rupture Treatment & Management

Updated: Dec 20, 2018
  • Author: Charles Nathan Webb, MD, MS; Chief Editor: Nicole W Karjane, MD  more...
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Treatment

Approach Considerations

Patients with presumed cyst rupture are typically managed conservatively. Conservative medical care may consist of outpatient treatment with oral analgesics in the stable patient, or if the clinical picture is evolving, admission and anticipatory management with serial abdominal examinations and laboratory testing, repeat imaging, and pain relief with an analgesic of choice. [16] Medications may range from oral acetaminophen to intravenous morphine via patient-controlled analgesia (PCA) infusion pumps. If continued bleeding is a concern or if the patient is unstable hemodynamically, proceed with surgery. [16]

Surgical care may entail laparoscopy or laparotomy, depending on clinical presentation, amount of blood in the abdomen, patient stability, and operator skill. [17, 18] Most bleeding can be stopped with suturing, cautery, cystectomy, or wedge resection. Occasionally, salpingo-oophorectomy is necessary.

For the patient with multiple episodes of ruptured physiologic cysts or following a single severe episode, it is reasonable to consider suppression of ovulation with oral hormonal contraception, as this may help reduce the risk of recurrence of ovarian cysts. [19]