Gynaecology, St Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia
Gynaecological Surgery, St Vincent's Institute for Minimally Invasive Surgery, Darlinghurst, New South Wales, Australia.
Postgrad Med J. 2022 Jul;98(1161):e9. doi: 10.1136/postgradmedj-2020-138833. Epub 2021 Mar 12.
Ruptured ovarian cysts are common gynaecological presentation to health institutions with abdominal pain. While this phenomenon is generally self-limiting, surgery may be necessary in cases of haemodynamic compromise or association with torsion. The aim of this audit is to identify the trend of hospital presentations, as well as the review the management of modern gynaecology practice.
A retrospective audit of all women who presented to the emergency department with an imaging diagnosis of ruptured ovarian cysts was conducted over a 5-year period at St Vincent's Hospital, Sydney.
During the study period, 408 women were identified. There was a trend towards conservative management, as observed in 84.7% of women, while the remaining 15.4% underwent surgery. Haemorrhagic or ruptured corpus luteum was the most common diagnoses. As expected, women who had surgical intervention were more likely to have larger cysts (20 vs 50%; p<0.05), and larger free fluid findings on imaging (1.4 vs 23.8%; p<0.05) compared with those managed conservatively. There were no statistically significant differences in location of ovarian cysts (right or left) or antecedent to hospital presentation (vaginal intercourse or trauma).
Ruptured ovarian cysts of both functional and non-functional types remained a common clinical presentation of acute pain for women to the emergency department. Majority of women were managed conservatively in our cohort, and indications for surgery were large ovarian cysts and large free fluid seen on imaging findings. Surgery was largely feasible with minimal complications.
破裂的卵巢囊肿是常见的妇科就诊原因，其症状表现为腹痛。尽管这种情况通常是自限性的，但在出现血流动力学不稳定或与扭转相关的情况下，可能需要手术治疗。本审计旨在确定医院就诊的趋势，并回顾现代妇科实践的管理情况。
对在悉尼圣文森特医院因影像学诊断为破裂卵巢囊肿而就诊于急诊科的所有女性进行了为期 5 年的回顾性审计。
在研究期间，共确定了 408 名女性。84.7%的女性倾向于保守治疗，15.4%的女性接受了手术治疗。黄体出血或破裂是最常见的诊断。正如预期的那样，接受手术干预的女性的囊肿更大（20%比 50%；p<0.05），影像学检查中发现的游离液体更多（1.4 比 23.8%；p<0.05），与接受保守治疗的女性相比。卵巢囊肿的位置（右侧或左侧）或就诊前的情况（阴道性交或创伤）无统计学显著差异。
功能性和非功能性破裂卵巢囊肿仍然是女性急诊科急性腹痛的常见临床表现。我们的研究队列中，大多数女性接受了保守治疗，手术的指征是影像学检查中发现的大卵巢囊肿和大量游离液体。手术具有较大的可行性，且并发症较少。
