Right lower Abdominal Pain In Young Lady -3 ~ From A Clinician's Bioscope

Young ladies some times complain of pain in the lower abdomen during menstruation.If it is in the right lower abdomen confuses with the common and dreaded ailment in that site,appendicitis.It is again difficult and at the same time easy to distinguish.It is a condition called A Ruptured Chocolate Cyst of Right Ovary.This cyst may occur in the either ovary and right side is important for us.Other innocent cause is dysmenorrhoea which is almost a self limiting condition .There are some other causes of academic interest.We will discuss chocolate cyst of ovary here.

Image by euthman via Flickr,Ovarian Cyst(Benign)

A chocolate cyst,the name is due to collection of of chocolate colored fluid in one or both ovaries.This occurs due to a condition called endometriosis where an inner lining of uterus called endometrium is found embeded in the ovary which is an ectopic site for that.There are so many ectopic sites for endometriosis.And is pathological.So,when menstrual cycle begins with menstrual bleeding due to shredding of endometrium in uterus also the same thing occurs in the other ectopic sites.And if an ectopic site is ovary there occurs bleeding.Which creates a space for itself and so become a cyst containing blood and some endometrium.This goes on in a cyclical manner with ever increasing size.Ultimately it can not accommodate more and bursts.
It causes pain in that side of lower abdomen ,vomiting and some times fever.And if it is in the right side teaches the surgeon a lesson in excluding it from appendicitis..But most commonly this ruptures around menstrual flow time though can occur at any time.An ultrasonogram is helpful besides the clinical examination.

Image by bc the path via Flickr,Ovarian Endometrial Cyst.

If conformed conservative management i.e. without surgery will resolve the condition.But some times surgical intervention is required. Laporoscopy is better idea over open surgery as at the first place it will confirm the actual condition basing on which further action can be taken.