In the management of this patient, obtaining more information about her presenting complaints is essential. The swelling may be associated with abdominal pain. If the pain is intermittent, then torsion may be a complication of the cyst. The pain may also be constant and increasing in intensity. This will point to the possibility of haemorrhage into an ovarian cyst. Where a cyst has ruptured, the pain tends to be excruciating and of very sudden onset. However, where the pain started intermittently and later became constant, the likely cause will be torsion. Associated symptoms may depend on the size of the ovarian cyst. These will usually be gastrointestinal and include dyspepsia, constipation and bloatedness of the abdomen.