Ovarian cyst: Difference between revisions
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==Background== | ==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== | ==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== | ==Differential Diagnosis== | ||
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==Workup== | ==Workup== | ||
*Bimanual exam | |||
**Adenexal mass | |||
**Adenexal tenderness | |||
*Ultrasound | |||
**Absence of cyst may suggest rupture | |||
==Management== | ==Management== | ||
*NSAIDs | *NSAIDs | ||
*Oral contraceptives | |||
**No benefit has been found though Gyn may suggest them<ref>Cochrane Database Syst Rev 2011. Sep 7;(9):CD006134.</ref> | |||
==Disposition== | ==Disposition== | ||
*Home | *Home | ||
*Follow up with OBGyn | |||
==See Also== | ==See Also== | ||
Revision as of 22:33, 30 December 2014
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
Right
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
Left
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
Workup
- Bimanual exam
- Adenexal mass
- Adenexal tenderness
- Ultrasound
- Absence of cyst may suggest rupture
Management
- NSAIDs
- Oral contraceptives
- No benefit has been found though Gyn may suggest them[1]
Disposition
- Home
- Follow up with OBGyn
See Also
External Links
Sources
- ↑ Cochrane Database Syst Rev 2011. Sep 7;(9):CD006134.