Occurrence, development and treatment of ovarian chocolate cyst

Ovarian chocolate cyst, also known as ovarian endometriosis cyst, is the most common condition of endometriosis. It can manifest as dysmenorrhea, menstrual abnormalities and infertility. It should be diagnosed and treated surgically as early as possible.

It has the following clinical characteristics:

1 About 80% of cases involve one ovary, and 50% involve both ovaries. Because the ectopic endometrium in the ovary repeatedly bleeds and forms single or multiple cysts, the cysts contain dark brown, sticky, old blood, which resembles chocolate liquid, so it is also called chocolate cyst.

2 Ultrasound characteristics: The cyst wall thickness is uneven, partitions are visible inside the cyst, and small light spots are reflected inside the cyst.

3. Cysts bleed, ooze and rupture repeatedly with menstruation, resulting in adhesion and immobility with the surrounding area, and rarely torsion. CA125 may increase, but generally does not exceed 200U/mL.

4 The size of the cyst is usually 5-6 cm. When both ovaries are affected, the cysts on both sides move closer to the middle of the pelvic cavity behind the uterus, forming a "kiss".

5. Rupture, secondary infection and malignant transformation may occur. The incidence of malignant transformation is about 0.7%. Severe cyst rupture may cause acute abdominal symptoms such as severe lower abdominal pain, which often occur before and after menstruation, during strenuous exercise or sexual intercourse, and require emergency medical treatment.

6 advocates early diagnosis and early treatment, and laparoscopic surgery is usually the first choice.