Ruptured or haemorrhagic ovarian cyst ⚠️ 🩺
🧠 Clinical mechanism: A functional cyst may rupture and cause sudden pelvic pain or intraperitoneal bleeding; differential diagnoses include torsion and ectopic pregnancy.
🔎 Recognise
- Sudden unilateral pelvic pain, often after exercise or sex, with variable nausea, peritonism or haemodynamic compromise.
🛟 First assessment and action
- Pregnancy test and ABCDE; treat pain, monitor observations and refer urgently to gynaecology when bleeding, severe pain or instability suspected.
🧪 Investigations and reassessment
- FBC, group-and-save when appropriate and pelvic ultrasound; serial assessment if concern for ongoing bleeding.
⚠️ Pitfall / escalation
- Do not diagnose a benign cyst by symptoms alone. A normal initial haemoglobin does not exclude acute haemorrhage.
UK reference: Primary NHS/NICE/RCOG/GMC source.
Editorial draft, 7 November 2026: targeted source-supported educational summary, NOT independent consultant/pharmacist verification or a treatment protocol. Follow up-to-date BNF, NICE and local NHS pathways.
Related: Ovarian torsion — acute pelvic pain 🚨 🩺 · Ectopic Pregnancy · Pelvic Pain