Ruptured Endometriotic Cyst Mimicking Acute Appendicitis During Pregnancy

Ali Özgür Ersoy, İrem Eda Gökdemir, Ebru Ersoy, Aykan Yücel
In: Gynecology Obstetrics & Reproductive Medicine · 2016 · vol. 22(2) , pp. 99–101 · doi:10.21613/gorm.2016.479 · W2417817477
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This case report describes a pregnant woman at 33 weeks gestation who presented with acute abdominal pain, leading to cesarean delivery and subsequent diagnosis of a ruptured endometriotic cyst.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

The paper describes a 21-year-old woman at 33 weeks’ gestation who presented with acute abdominal pain localized to the right lower quadrant with guarding and rebound tenderness, leukocytosis, and fetal heart rate decelerations but no preterm labor or placental abruption. Ultrasound confirmed a live fetus and normal amniotic fluid, and due to the nonfavorable fetal testing an emergency cesarean section followed by abdominal exploration was performed for presumed acute appendicitis–like presentation. During exploration, the peritoneum was coated with dark red-brown dense material, and two left ovarian endometriotic cysts were found, one ruptured (about 6 cm) with the other intact (2–3 cm), with both cysts excised and pathology confirming endometriotic cysts; the report notes no postoperative problems over two days. This paper is centrally about endometriosis — it documents a ruptured endometriotic cyst in late pregnancy mimicking acute appendicitis.

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Abstract

A 21-year-old primigravid pregnant woman of 33 gestational weeks applied to our Perinatology Clinic with acute abdominal pain. The pain was spreading from the midline to the right lower quadrant of the abdomen. Guarding and rebound tenderness existed in the right lower quadrant. An ultrasonographic examination revealed a single alive fetus and normal amniotic fluid. A whole blood count revealed leukocytosis and there were no signs of preterm labor or placental abruption. Fetal heart rate decelerations in a non-stress test were observed, and a decision for cesarean section and abdominal exploration were made.A healthy male baby of 2,500 grams was delivered. In the abdominal exploration, all peritoneal surfaces were coated with a dark red- to brown-colored dense material, like mud. There were two endometriotic cysts in the left ovary; one had a 6-cm mean diameter and was ruptured, while the other was intact and had a mean diameter of 2–3 cm. Both cysts were excised and sent for pathologic examination. The patient had no postoperative problems over two days and was discharged. The final pathologic diagnosis was endometriotic cysts.

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