Tubal pregnancies - this is called an ectopic. Once in a while the pregnancy develops in the tube before it makes it down and these conditions are life threatening. Most of them are not, but in the process the tube can fill up with blood and before it ruptures. And this can also appear on ultrasound as a cyst and it can feel like a cyst. Most of the time a pregnancy test will be positive, and when you combine that with the enlarged tube, well you’ve got your diagnosis and saved an emergency.
We’ve talked about endometriosis, that which can be a cyst. They’re rare types of colon tumors, most of these are solid bowel abscesses, can be sometimes diverticulosis, diverticulitis. You can have abscesses that can feel - most of these, well they can feel, or present like a cyst, and they’re going to be painful. Most ovary cysts in and of themselves are not going to be causing a problem. And there are a couple of other conditions that can be mistaken for a pelvic tumor. They’re not cysts but I’m going to mention them; uterus fibroids or uterine myomas, and pelvic kidney’s. The kidney actually migrates during development.
A lot of strange stuff happens to us. We’re lucky that so many of us are normal. The pelvic kidney sometimes remains in the pelvis and can feel like a tumor until the proper tests are done to identify it as a kidney. So, during the work up process all these things are considered. But, the important thing here, is that cysts themselves, in and of themselves are not going to be a problem or life threatening problem. In his white paper, New York OB/GYN Christopher Freville discusses the complications of cysts.
What are the complications of the cyst? Well, first and foremost if any cyst, any of these types of cysts we talked about; the benign ones can cause a problem if they get so large that they start twisting, called torsion. And, when an ovary generally gets bigger than 10 centimeters that can be a problem. I’ve seen it less than that, but when the ovary starts twisting itself just imagine a tube with a big ball on the end and by movement or whatever this tube gets twisted and twisted. You ultimately end up shutting down the blood supply and causing that particular ovary tube, called the addnexit to loose it’s blood supply, become necrotic, which means tissue dies, and it has to be removed.
Well, prior to that process it’s extremely painful. Most of the time those torsed ovaries cannot be saved. Which is not a problem because just like kidneys, just like testis, women with one ovary can have just as many babies as a woman with two ovaries and two tubes. So it doesn’t decrease the fertility by half which is a common misconception. So we’ve got torsion as a complication. Obviously the pain is a definite complication and if the pain persists, well it’s time to have something done. The complications of endometriomas of course, and polycysticomas; the most common ones are infertility.
The endometriomas, if they persist, and there’s continuous bleeding in the abdomen and the ovary that can cause adhesions. Any bleeding cyst can be a problem. Any cyst can have a blood supply. Most of these, the bigger blood supplies, the bigger blood vessels on cysts are usually the corpus luteum cyst. A pregnancy with a corpus luteum, the second type of functional cyst goes on to develop as the baby is growing. The blood supply is very, very rich and they break, they burst, they rupture a vessel can pump blood into the abdomen and can be a life threatening condition. The same thing can be true with, certainly with tube pregnancies, that’s why those two can be confused. So, you can have bleeding with a cyst but most of the time those are rare circumstances. Torsion, bleeding, when it ruptures most of the time there’s going to be pain.
by: Hillary Templeton
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