Diagnostic imaging of ovarian endometrioma rupture with hemoperitoneum

Abstract

An endometrioid ovarian cyst (known as endometrioma) is the most common variant of external endometriosis. Clinical symptoms range from asymptomatic to negatively affecting on quality of life and daily activities of a reproductive age woman. Rupture of an endometrioid cyst with hemorrhage into the abdominal cavity occurs in 3% of women with this pathology, which is a rare complication.
 Ruptured endometrioid cysts may present a diagnostic and surgical challenge: patients may have acute abdominal symptoms and hemodynamic instability, also imaging of a ruptured endometrioid cyst may mimic ovarian malignancy. Therefore, the emergency radiologist needs to know the semiotics of an endometrioid cyst with rupture and hemorrhage into the abdominal cavity.
 We represent the clinical case of a prime diagnosed large endometrioid cyst in a 32-year-old patient, complicated by hemorrhage in the abdominal cavity. In the emergency department, the patient underwent native computed tomography and ultrasound investigation.
 Based on the study of Russian and foreign literature, the review was made about main aspects of radiation semiotics of endometrioid cysts with rupture and hemorrhage in the abdominal cavity and about of differential diagnosis of rupture of endometrioid cysts with ruptures of functional cysts and malignant cystic ovarian formations.