What is the role of imaging studies in the workup of ovarian cyst rupture?

Updated: Dec 20, 2018
  • Author: Charles Nathan Webb, MD, MS; Chief Editor: Nicole W Karjane, MD  more...
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Answer

Ultrasonography is the preferred imaging modality for assessing gynecologic structures, given its low cost, availability, and sensitivity in recognizing adnexal cysts and hemoperitoneum. [10, 11] Despite this, there remain instances in which the ultrasound findings are nonspecific, particularly after rupture and decompression of a cyst in the setting of apparent physiologic levels of fluid in the pelvis.

If ultrasound yields ambiguous results in a patient with significant pain, computed tomography (CT) of the pelvis with contrast should be performed. CT features of corpus luteum cysts have been previously described. [12, 13, 14]

Although commonly performed in the past, culdocentesis has been largely abandoned in favor of ultrasonography and CT scanning, as both can readily identify fluid collections in the cul-de-sac. Culdocentesis is still acceptable, however, in locations where imaging is not available.


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