The study of emergency laparoscopic surgery for gynecological diseases: Can we predict the rupture of ovarian endometriotic cyst?

Ayumi Matsumoto, Akira Fujishita, Daisuke Nakayama, Shikou Yoshida, Tomoko Shimomura, Ayumi Ogino, Maki Kurosaki, Kouhei Kotera, Kazunori Minami
In: JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY · 2011 · vol. 27(1) , pp. 284–289 · doi:10.5180/jsgoe.27.284 · W2324723756
article OA: bronze CC0
🔓 Open OA copy Full text JSON View on OpenAlex View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This retrospective study of 1,847 emergency laparoscopic surgeries found that patient age, leukocyte count, and rebound tenderness significantly differed between ruptured and un-ruptured ovarian endometriotic cysts.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 · read from full text ⓘ

This retrospective study analyzed 1,847 patients undergoing emergency gynecologic laparoscopic surgery at two hospitals between 2005 and 2010, comparing those with ruptured versus un-ruptured ovarian endometriotic cysts using operative reports, video images, and laboratory data. Among 334 emergency operations, preoperative diagnoses included 37 suspected ruptured endometriotic cysts and 43 diagnosed ovarian bleeding; at surgery, 10 of the suspected ruptures were un-ruptured and 2 ovarian-bleeding cases were found to be ruptured endometriotic cysts. In the ruptured group (n=29) versus un-ruptured group (n=10), higher age, higher leukocyte count, and a greater incidence of rebound tenderness were significantly associated with rupture, while imaging and other measured factors did not establish accurate diagnosis. The paper concludes that accurate preoperative diagnosis is difficult and emphasizes the role of careful physical examination and clinical assessment, with the main limitation being its reliance on retrospective review and preoperative diagnostic labels. This paper is centrally about endometriosis — it investigates predictors of rupture of ovarian endometriotic cysts in emergency laparoscopic surgery.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

Objective: We investigated emergency laparoscopic surgery for gynecological disease in our hospital, and analyzed the clinical characteristics of patients and findings of ruptured vs. un-ruptured ovarian endometriotic cyst.Design: From April 2005 to March 2009 and April 2009 to September 2010, we treated a total 1,847 patients by laparoscopic surgery at Nagasaki Municipal Hospital (1251 cases) and Saiseikai Nagasaki Hospital (596 cases). We retrospectively analyzed operative reports, video images and laboratory data.Result: The frequency of emergency operation was 18% (334/1,847cases) during this period. Preoperative clinical diagnosis was as follows: ectopic pregnancy (166 cases), torsion of ovarian tumor (55 cases), ovarian bleeding (43 cases), ruptured ovarian endometriotic cyst (37 cases), pelvic inflammatory disease (11 cases), and other (20 cases). Among the 37 patients with suspected cases of ruptured ovarian endometriotic cyst before surgery, 10 cases were found un-ruptured at laparoscopic surgery. Among the 43 patients diagnosed preoperatively with ovarian bleeding, two cases were found to be ruptured endometriotic cyst at laparoscopic surgery. We compared cases in the ruptured group (n=29) versus the un-ruptured group (n=10) according to preoperative clinical and laboratory findings including age of the patient, affected site (right or left), body temperature, tenderness of cul-de-sac, rebound tenderness, leukocyte count, serum CRP/CA125 level, diameter of the tumor, and MRI findings. We found that the age of the patient (33.6 ± 7.8 vs. 28.1 ± 5.1yrs), the leukocyte count (11,993 ± 4,127 vs. 8,500 ± 4,046/μl), and the incidence of rebound tenderness (96% vs. 22%) were significantly higher in the ruptured group when compared with the un-ruptured group. Conclusion: A substantial proportion of patients with ovarian endometriotic cyst were found with ruptured cysts during emergency laparoscopic surgery at our hospital. Although it is relatively difficult to accurately diagnose ruptured ovarian endometriotic cyst, careful physical examination and clinical investigation are essential in the preoperative assessment of patients with suspected ruptured ovarian endometriotic cyst.
Full text 4,547 characters · extracted from oa-doi-fallback · 5 sections · click to expand

Abstract

Objective: We investigated emergency laparoscopic surgery for gynecological disease in our hospital, and analyzed the clinical characteristics of patients and findings of ruptured vs. un-ruptured ovarian endometriotic cyst. Design: From April 2005 to March 2009 and April 2009 to September 2010, we treated a total 1,847 patients by laparoscopic surgery at Nagasaki Municipal Hospital (1251 cases) and Saiseikai Nagasaki Hospital (596 cases). We retrospectively analyzed operative reports, video images and laboratory data.

Result

The frequency of emergency operation was 18% (334/1,847cases) during this period. Preoperative clinical diagnosis was as follows: ectopic pregnancy (166 cases), torsion of ovarian tumor (55 cases), ovarian bleeding (43 cases), ruptured ovarian endometriotic cyst (37 cases), pelvic inflammatory disease (11 cases), and other (20 cases). Among the 37 patients with suspected cases of ruptured ovarian endometriotic cyst before surgery, 10 cases were found un-ruptured at laparoscopic surgery. Among the 43 patients diagnosed preoperatively with ovarian bleeding, two cases were found to be ruptured endometriotic cyst at laparoscopic surgery. We compared cases in the ruptured group (n=29) versus the un-ruptured group (n=10) according to preoperative clinical and laboratory findings including age of the patient, affected site (right or left), body temperature, tenderness of cul-de-sac, rebound tenderness, leukocyte count, serum CRP/CA125 level, diameter of the tumor, and MRI findings. We found that the age of the patient (33.6 ± 7.8 vs. 28.1 ± 5.1yrs), the leukocyte count (11,993 ± 4,127 vs. 8,500 ± 4,046/μl), and the incidence of rebound tenderness (96% vs. 22%) were significantly higher in the ruptured group when compared with the un-ruptured group.

Conclusion

A substantial proportion of patients with ovarian endometriotic cyst were found with ruptured cysts during emergency laparoscopic surgery at our hospital. Although it is relatively difficult to accurately diagnose ruptured ovarian endometriotic cyst, careful physical examination and clinical investigation are essential in the preoperative assessment of patients with suspected ruptured ovarian endometriotic cyst. Design: From April 2005 to March 2009 and April 2009 to September 2010, we treated a total 1,847 patients by laparoscopic surgery at Nagasaki Municipal Hospital (1251 cases) and Saiseikai Nagasaki Hospital (596 cases). We retrospectively analyzed operative reports, video images and laboratory data.

Result

The frequency of emergency operation was 18% (334/1,847cases) during this period. Preoperative clinical diagnosis was as follows: ectopic pregnancy (166 cases), torsion of ovarian tumor (55 cases), ovarian bleeding (43 cases), ruptured ovarian endometriotic cyst (37 cases), pelvic inflammatory disease (11 cases), and other (20 cases). Among the 37 patients with suspected cases of ruptured ovarian endometriotic cyst before surgery, 10 cases were found un-ruptured at laparoscopic surgery. Among the 43 patients diagnosed preoperatively with ovarian bleeding, two cases were found to be ruptured endometriotic cyst at laparoscopic surgery. We compared cases in the ruptured group (n=29) versus the un-ruptured group (n=10) according to preoperative clinical and laboratory findings including age of the patient, affected site (right or left), body temperature, tenderness of cul-de-sac, rebound tenderness, leukocyte count, serum CRP/CA125 level, diameter of the tumor, and MRI findings. We found that the age of the patient (33.6 ± 7.8 vs. 28.1 ± 5.1yrs), the leukocyte count (11,993 ± 4,127 vs. 8,500 ± 4,046/μl), and the incidence of rebound tenderness (96% vs. 22%) were significantly higher in the ruptured group when compared with the un-ruptured group.

Conclusion

A substantial proportion of patients with ovarian endometriotic cyst were found with ruptured cysts during emergency laparoscopic surgery at our hospital. Although it is relatively difficult to accurately diagnose ruptured ovarian endometriotic cyst, careful physical examination and clinical investigation are essential in the preoperative assessment of patients with suspected ruptured ovarian endometriotic cyst. © 2011 Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy Favorites & Alerts Recently viewed articles

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

⚙ Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback ⓘ

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Citation neighborhood (sparse)

Too few in-corpus citations on either side for a chart; here are the lists.

Cites (3)

References (9)

Source provenance

openalex
last seen: 2026-06-10T17:14:06.276822+00:00
License: CC0 · commercial use OK