Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2021; 9(28): 8524-8530
Published online Oct 6, 2021. doi: 10.12998/wjcc.v9.i28.8524
Rupture of ovarian endometriotic cyst complicated with endometriosis: A case report
Lu Wang, Yan-Jiao Jiang
Lu Wang, Yan-Jiao Jiang, Department of Gynecology, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, Zhejiang Province, China
Author contributions: Wang L design the experiment; Wang L drafted the work, Jiang YJ collected the data; Wang L and Jiang YJ analysed and interpreted data, Lu Wang wrote the article.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: No conflict of interest.
CARE Checklist (2016) statement: The manuscript was revised according to the CARE Checklist (2016) statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Yan-Jiao Jiang, MD, Chief Doctor, Department of Gynecology, The Third Affiliated Hospital of Zhejiang Chinese Medical University, No. 219 Moganshan Road, Xihu District, Hangzhou 310005, Zhejiang Province, China.
Received: May 18, 2021
Peer-review started: May 18, 2021
First decision: June 15, 2021
Revised: June 29, 2021
Accepted: August 2, 2021
Article in press: August 2, 2021
Published online: October 6, 2021

Endometriosis (EMs), an estrogen-dependent disease, refers to the appearance of mucosa-covered endometrial tissues (glandular and interstitial) growing in the uterine cavity outside the uterine myometrium. It is commonly seen in women aged 25 to 45, with an incidence of approximately 10%-15%.


A 35-year-old unmarried female who denied a history of sex with an intact hymen had multiple dysmenorrhea and pain in the left lower abdomen that recurred during menstruation. Ultrasound examination revealed a dark cystic area measuring 4.9 cm × 4.6 cm on the left side with poor light transmittance, which suggested a left endometriotic cyst. The patient was treated with pain medications (four capsules t.i.d., p.o.). After one month, computed tomography of the abdomen and pelvis revealed a low-density focus measuring approximately 38 mm in diameter, a blurred mesentery fat plane in the pelvic cavity, and pelvic effusion. Ultrasound showed a complex echo density measuring 5.2 cm × 3.0 cm × 4.2 cm in the left ovarian area and a fluid sonolucent area with a depth of 2.0 cm in the pelvic cavity. Left ovarian cystectomy, electrocautery for endometriotic lesions, myomectomy, and pelvic adhesion lysis were performed under laparoscopy. The postoperative diagnosis was left ovarian chocolate cyst rupture and EMs (stage III, ovarian type, peritoneal type).


Laparoscopic surgery can safely control the symptoms of EMs and effectively eradicate the disease.

Keywords: Ovary, Rupture of endometriotic cyst, Endometriosis, Laparoscopic surgery, Case report

Core Tip: With the advancement of laparoscopic technology, minimally invasive laparoscopic surgery has successfully become the treatment option for ruptured chocolate cysts. We would like to share our experience of laparoscopic treatment of ruptured ovarian endometriotic cysts.