Endoscopic management of ruptured ovarian cyst complicated by hemoperitoneum associated with early pregnancy at Nevers hospital (France)

Abstract

 Case report This was a 25-year-old, third gestational, primiparous patient with a history of early spontaneous miscarriage. She presented with 10 weeks of secondary amenorrhea associated with sympathetic signs of pregnancy. Ultrasound revealed a 10-week active pregnancy and a large, benign, organic-looking left ovarian cyst measuring 90 mm x 65 mm. Biological investigations confirmed that the cyst was probably benign. A plan for monitoring the pregnancy and the cyst was put in place. This involved fortnightly ultrasound scans. One week after diagnosis of the cyst, the patient was seen in emergency with severe abdominal pain. Emergency investigations led to the suspicion of hemoperitoneum. Laparoscopic cystectomy was performed, enabling removal of the remaining cyst and aspiration of the hemoperitoneum. The pregnancy continued without complications related to the surgical procedure.