ABSTRACT
Complications of ovarian cysts, such as rupture, hemorrhage, torsion, and infections, frequently cause acute pain and may lead to a significant proportion of emergency department visits. The vessels within the corpus luteum wall are thin and tend to bleed, forming a hemorrhagic cyst. The presentation of a ruptured or hemorrhagic cyst ranges from asymptomatic to circulatory collapse. The appearance of a hemorrhagic cyst is variable depending on the age of the bleed. Functional follicular and hemorrhagic ovarian cysts occur almost exclusively in premenopausal women and in postmenopausal women receiving hormonal treatment. The Society of Radiologists in Ultrasound and a panel of experts arrived at a consensus statement regarding the management of hemorrhagic and simple cysts. Acute complications include torsion of pedunculated fibroid, venous thrombosis, red degeneration, and acute vaginal or intraperitoneal hemorrhage. In conclusion, the current evidence strongly suggests conservative management as the preferred treatment of a ruptured or hemorrhagic ovarian cyst.
