Ruptured Ovarian Cyst vs. Adnexal torsion - USMLE Forums
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Old 05-10-2016
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Default Ruptured Ovarian Cyst vs. Adnexal torsion

Hi guys,

I have a question regarding ruptured ovarian cyst and adnexal torsion. What is the main difference between them? I keep getting confused.
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Old 05-10-2016
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Adnexal torsion - sudden onset of severe pelvic pain associated with nausea and vomiting in a women with adnexal mass. USG might show an adnexal mass. Definitive Dx on direct visualization of the twisted ovary/fallopian tube on laparascopy/lapartomy
Ruptured ovarian cyst - sudden onset of severe pain immediately following sexual activity (or any strenuous physical activity). If there is enough bleeding, may be associated with hemodynamic instability. USG - combination of ovarian cyst + serous fluid/blood in the pelvic cavity
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Old 05-11-2016
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Quote:
Originally Posted by britesky89 View Post
Hi guys,

I have a question regarding ruptured ovarian cyst and adnexal torsion. What is the main difference between them? I keep getting confused.
ovarian/adnexal torsion:

risk factors: ovarian mass,women of reproductve age,pregnancy,infertility treatmnt with ovulation induction.
c/o: suden onset of mod to severe pelvic pain(right sided mc),unilateral and tender mass,nausea vomiting,low grade fever,vaginal bleeding les comon.
on exam: palpable and tender adnexal mass, on u/s: with color dopler reveal an enlarged edematous ovary with localized tenderness and signs of impaired ovarian blood flow.
Mx : detorsion with emergency laparoscopic surgery (untreated torsion leads chronic pelvic pain,infertility ,hemorhage,peritonitis and sepsis).

ovarian rupture:

abdominal pain often folowing sternous activity or sexual intercourse.
c/o: suden onset of lowr abdominal pain (at mid cycle),may b acompanied by light vaginal bleeding,nausea and vomiting les comon,in rare cases significant hemorhage leads shock and hemoperitoneum.
on exam: tendernes to palpation of lower abdomen and posibly adnexal mass on bimaual examination,with significant intraperitoneal bleeding may show periumbilical ecchymoses (culen's sign).
u/s wil show free fluid near ovarian cyst.

Mx : uncomplicated rupture (no systemic signs or hemoperitoneum) managed conservativerly,complicated cyst rupture eg unstable or have significant hemoperitoneum requires surgery.
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Old 05-26-2016
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Thank you! I've had the same question!
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