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Suggest Treatment For Symptoms Of Cyst Rupture Or Ovarian Torsion
Question: Related to a friend,
She had her periods on 1st of December, but after that was not getting them. So she took “Regulin” tablets, 2 each day together on 6th, 7th and 8th of January. Still periods didn’t come. Pregnancy tests were negative. Still, suspecting pregnancy, she visited a doctor who gave her DUB-5 tablets, 5 day course. Doctor said that these should induce her periods by 5th of February. Doctor also prescribed an ultrasound for PCOD. Medicines were taken from 26th to 30th (5days) 2 tablets after dinner. Periods still didn’t come and the doctor went out of station so couldn't be consulted. Meanwhile, ultrasound was conducted on 1st of February; report has been in attached. Finally, she had her periods on 12th of February. The flow wasn’t very good and almost dried out after 3rd day. Now she’s facing acute pain in right ovary and sometimes in both ovaries simultaneously, extending till thighs, which is getting worse by the day.
So we’d like to know your assessment of the report.
Also, and importantly, if another doctor is to be visited (with guardians), would the medical history be reflected ? Like traces of medicines or any other symptoms that may indicate that she had been medicated before; as all this was done without informing them, but considering that pain is chronic, guardians have to be involved. If yes, then how much time should we wait before the symptoms go away.
She had her periods on 1st of December, but after that was not getting them. So she took “Regulin” tablets, 2 each day together on 6th, 7th and 8th of January. Still periods didn’t come. Pregnancy tests were negative. Still, suspecting pregnancy, she visited a doctor who gave her DUB-5 tablets, 5 day course. Doctor said that these should induce her periods by 5th of February. Doctor also prescribed an ultrasound for PCOD. Medicines were taken from 26th to 30th (5days) 2 tablets after dinner. Periods still didn’t come and the doctor went out of station so couldn't be consulted. Meanwhile, ultrasound was conducted on 1st of February; report has been in attached. Finally, she had her periods on 12th of February. The flow wasn’t very good and almost dried out after 3rd day. Now she’s facing acute pain in right ovary and sometimes in both ovaries simultaneously, extending till thighs, which is getting worse by the day.
So we’d like to know your assessment of the report.
Also, and importantly, if another doctor is to be visited (with guardians), would the medical history be reflected ? Like traces of medicines or any other symptoms that may indicate that she had been medicated before; as all this was done without informing them, but considering that pain is chronic, guardians have to be involved. If yes, then how much time should we wait before the symptoms go away.
Brief Answer:
possible cyst rupture or ovarian torsion...visit ER soon
Detailed Answer:
Hello,
Thanks for the query to HCM,
It is evident from the reports and the prescription that she has irregular cycles and often 35-60 days cycle which makes her oligomenorrhoeic. The Ultrasound report shows a pregnancy free uterus, with an endometrial thickness of 11mm which is not high after 2 months of amenorrhoea. It also shows a small hemorrhagic ovarian cyst in the right ovary of size approx 3x3 cm.
The likely cause of acute onset pain over the right side of the lower abdomen after the menses has terminated , was a probable stretching of the cyst capsule due to developing follicles under the estrogen effect for the fresh cycle and there may be a possibility of cyst rupture and that being the cause of acute onset pain. The ruptured cyst can cause the fluid released to be collected in the pouch of XXXXXXX and can cause feeling of fullness in the lower abdomen with pain distribution along the lower back and towards the inner thighs.
It is important that she should taken to the ER, for a follow up ultrasound abdomen and pelvis with doppler studies to check for ruptured cyst or a possible OVARIAN TORSION as WELL which has a similar presentation. If its a torsion then she would need an urgent laparoscopic surgery to untort the ovarian pedicle and restore blood supply.
Guardians have to be informed and taken along to the ER.
Regards
possible cyst rupture or ovarian torsion...visit ER soon
Detailed Answer:
Hello,
Thanks for the query to HCM,
It is evident from the reports and the prescription that she has irregular cycles and often 35-60 days cycle which makes her oligomenorrhoeic. The Ultrasound report shows a pregnancy free uterus, with an endometrial thickness of 11mm which is not high after 2 months of amenorrhoea. It also shows a small hemorrhagic ovarian cyst in the right ovary of size approx 3x3 cm.
The likely cause of acute onset pain over the right side of the lower abdomen after the menses has terminated , was a probable stretching of the cyst capsule due to developing follicles under the estrogen effect for the fresh cycle and there may be a possibility of cyst rupture and that being the cause of acute onset pain. The ruptured cyst can cause the fluid released to be collected in the pouch of XXXXXXX and can cause feeling of fullness in the lower abdomen with pain distribution along the lower back and towards the inner thighs.
It is important that she should taken to the ER, for a follow up ultrasound abdomen and pelvis with doppler studies to check for ruptured cyst or a possible OVARIAN TORSION as WELL which has a similar presentation. If its a torsion then she would need an urgent laparoscopic surgery to untort the ovarian pedicle and restore blood supply.
Guardians have to be informed and taken along to the ER.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
the second part of the question remains unanswered that if she goes to the doctor with guardians, will the medical history be reflected.
this is the critical part as it will be hard to explain the previous scenarios and circumstances. so if she is taken to the doctor, can it look like a fresh case, one with no medical history and just a missed period or something?
would any reports reflect that she'd taken the before mentioned prescriptions.?
this is the critical part as it will be hard to explain the previous scenarios and circumstances. so if she is taken to the doctor, can it look like a fresh case, one with no medical history and just a missed period or something?
would any reports reflect that she'd taken the before mentioned prescriptions.?
Brief Answer:
it will be a fresh case.
Detailed Answer:
hello,
I REALLY DON'T THINK previous history would be required and she can present as a case of paining abdomen sudden onset with history of delayed menses.
It can look as a fresh case.
it will be a fresh case.
Detailed Answer:
hello,
I REALLY DON'T THINK previous history would be required and she can present as a case of paining abdomen sudden onset with history of delayed menses.
It can look as a fresh case.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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