Presentation
Acute lower abdominal pain.
Patient Data
There is a heterogenous avascular lesion arising from the right ovary; the remaining right ovarian parenchyma shows preserved Doppler activity.
A heterogenous irregular lesion is seen on the right side of the pelvis; it appears hyperdense on precontrast imaging with blood density.
The right gonadal vein can be traced reaching the lesion, indicating ovarian/adnexal origin.
No active contrast extravasation.
Moderate amount of dense ascites.
Unremarkable appendix.
Case Discussion
This patient presented with acute lower abdominal pain and suspected appendicitis. In the light of negative Beta-HCG and a normal-appearing appendix, the diagnosis of a ruptured ovarian cyst was given with high certainty.
On laparoscopic evaluation, a ruptured hemorrhagic cyst was found.
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