View source for Ovarian cyst

==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

[[File:Relative incidences of ovarian cysts.jpg|thumb|Relative incidences of different types of ovarian cysts.<ref> Abduljabbar, Hassan S.; Bukhari, Yasir A.; Hachim, Estabrq G. Al; Ashour, Ghazal S.; Amer, Afnan A.; Shaikhoon, Mohammed M.; Khojah, Mohammed I. (July 2015). "Review of 244 cases of ovarian cysts". Saudi Medical Journal. 36 (7): 834–838. doi:10.15537/smj.2015.7.11690. PMC 4503903. PMID 26108588.</ref>]]

==Clinical Features==
*Most tend to be asymptomatic
*Can cause:
**Dull [[pelvic pain]] or fullness; they can be significantly painful if ruptured
**Dyspareunia
**Pressure on the bladder
*If there is bleeding into the cyst and it ruptures, it can be life threatening, with signs of [[peritonitis]], [[shock]]

==Differential Diagnosis==
{{Pelvic pain DDX}}
{{Abd DDX RLQ}}
{{LLQ DDX}}

==Evaluation==
[[File:PMC4603210 usg-15013-f2.png|thumb|Ultrasound demonstrates a simple ovarian cyst greater than 3 cm in size consistent with a follicular cyst.]]
[[File:Ovarian Cyst Singh.gif|thumbnail|Transvaginal ultrasound showing ovarian cyst<ref>http://www.thepocusatlas.com/obgyn/</ref>]]
[[File:PMC3369119 13244 2012 157 Fig2 HTML.png|thumb|Ruptured hemorrhagic cyst. (a) CT with bilateral low-density cystic lesions (white arrows). There is extensive hyperdense free pelvic fluid representing hemorrhagic ascites (black arrow). (b) Trans-abdominal ultrasound shows free fluid containing low level echoes in the pelvis (black arrow). There is an adnexal cyst in the pelvis representing the right hemorrhagic ovarian cyst (white arrow).]]
===Workup===
*CBC, chemistry
*[[UA]], urine pregnancy
*[[Pelvic ultrasound]]
*Consider CT A/P to rule out other etiologies (e.g. [[appendicitis]])

===Diagnosis===
*Typically diagnosed on ultrasound, with same side of pain and absence of other concerning etiologies (e.g. negative UA, not pregnant)
*Check hemoglobin level to assess for blood loss

==Management==
*[[NSAIDs]]
*Oral contraceptives
**No benefit has been found though gynecology may suggest them<ref>Cochrane Database Syst Rev 2011. Sep 7;(9):CD006134.</ref>
*Ensure that patient does not have significant anemia/free fluid in pelvis
**Consider repeat hemoglobin of observation period if concern for ruptured cyst with significant bleeding

==Disposition==
*Home, unlessed ruptured with concern for significant blood loss
*Follow up with OBGyn

==See Also==
*[[Abdominal Pain]]

==External Links==

==References==
<references/>

[[Category:OBGYN]]