Ovarian cyst: Difference between revisions
| Line 20: | Line 20: | ||
==Evaluation== | ==Evaluation== | ||
===Workup=== | |||
*CBC, chemistry | |||
*UA, urine pregnancy | |||
*Pelvic ultrasound | |||
*Consider CT A/P to rule out other etiologies (e.g. [[appendicitis]]) | |||
===Diagnosis=== | |||
[[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: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:Ovarian Cyst Singh.gif|thumbnail|Transvaginal ultrasound showing ovarian cyst<ref>http://www.thepocusatlas.com/obgyn/</ref>]] | ||
* | *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== | ==Management== | ||
Revision as of 18:39, 1 July 2019
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
Clinical Features
- Most tend to be asymptomatic
- Can cause:
- Dull pelvic pain or fullness
- Dyspaneuria
- Pressure on the bladder
- They can be significantly painful if ruptured
- If there is bleeding into the cyst and it ruptures, it can be life threatening
Differential Diagnosis
RLQ Pain
- GI
- Appendicitis
- Perforated appendicitis
- Peritonitis
- Crohn's disease (terminal ileitis)
- Diverticulitis (cecal, Asian patients)
- Inguinal hernia
- Mesenteric ischemia
- Ischemic colitis
- Meckel's diverticulum
- Neutropenic enterocolitis (typhlitis)
- Appendicitis
- GU
- Other
LLQ Pain
- Diverticulitis
- Kidney stone
- UTI
- Pyelonephritis
- Ectopic pregnancy
- Infectious colitis
- Inflammatory bowel disease (Crohn's Disease, Ulcerative Colitis)
- Inguinal hernia
- Mesenteric ischemia
- Epiploic appendagitis
- Mittelschmerz
- Ovarian cyst
- Ovarian torsion
- PID
- Psoas abscess
- Testicular torsion
- Appendicitis
- Abdominal aortic aneurysm
- Herpes zoster
- Endometriosis
- Colon cancer
- Irritable bowel syndrome
- Small bowel obstruction
Evaluation
Workup
- CBC, chemistry
- UA, urine pregnancy
- Pelvic ultrasound
- Consider CT A/P to rule out other etiologies (e.g. appendicitis)
Diagnosis
Transvaginal ultrasound showing ovarian cyst[1]
- 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
Disposition
- Home
- Follow up with OBGyn
See Also
External Links
References
- ↑ http://www.thepocusatlas.com/obgyn/
- ↑ Cochrane Database Syst Rev 2011. Sep 7;(9):CD006134.