• B S Hertzberg, M A Kliewer, and E K Paulson.
• Duke University Medical Center, Department of Radiology, Box 3808, Room 24244B, Red Zone, South, Durham, NC 27710, USA.
• Abdom Imaging. 1999 May 1; 24 (3): 304-8.

BackgroundTo describe the spectrum of imaging findings and clinical presentations produced after rupture and hemorrhage of an ovarian cyst.MethodsImaging studies and hospital records of nine patients who were ultimately diagnosed with hemoperitoneum from a ruptured ovarian cyst were reviewed and categorized.ResultsHemoperitoneum from a ruptured ovarian cyst presented a range of imaging findings. Although the imaging findings were dominated by hemoperitoneum, at least a vestige of the cyst could be identified in seven patients. The diagnosis of hemoperitoneum from a ruptured ovarian cyst was favored in only four of nine patients after the initial imaging study.ConclusionsA ruptured ovarian cyst can produce massive hemoperitoneum, with clinical symptomatology and sonographic features that closely mimic those of other disorders, in particular ectopic pregnancy. Considering the likelihood of both clinical and radiologic misdiagnosis, the radiologist should consider and pursue the diagnosis of a ruptured hemorrhagic ovarian cyst in a woman of child-bearing age who presents with pelvic pain and a large amount of complicated intraperitoneal fluid.

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