Ruptured Endometriotic Cyst Mimicking Acute Appendicitis During Pregnancy

Abstract

A 21-year-old primigravid pregnant woman of 33 gestational weeks applied to our Perinatology Clinicwith acute abdominal pain. The pain was spreading from the midline to the right lower quadrant of theabdomen. Guarding and rebound tenderness existed in the right lower quadrant. An ultrasonographicexamination 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 decelerationsin a non-stress test were observed, and a decision for cesarean section and abdominal exploration weremade. A healthy male baby of 2,500 grams was delivered. In the abdominal exploration, all peritoneal surfaceswere coated with a dark red- to brown-colored dense material, like mud. There were two endometrioticcysts in the left ovary; one had a 6-cm mean diameter and was ruptured, while the other was intact andhad 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 diagnosiswas endometriotic cysts.