SPONTANEOUS HEMOPERITONEUM DUE TO RUPTURED OVARIAN ENDOMETRIOMA: A MIMICKER OF GYNECOLOGICAL AND SURGICAL ACUTE ABDOMEN

Abstract

DOI: https://doi.org/10.46296/gt.v9i18.0408

Abstract

Background: Spontaneous rupture of an ovarian endometrioma may present as an acute abdomen and mimic gynecological or general surgical emergencies. Leakage of endometrioma contents can cause chemical peritonitis, blood-stained ascites, or variable-volume hemoperitoneum; these presentations should not be considered interchangeable. Objective: To synthesize clinical manifestations, diagnostic findings, and therapeutic approaches described in reports of ovarian endometrioma rupture. Methods: A structured PubMed literature search was performed on October 10, 2026, with the same date as the publication cutoff (earliest eligible publication: January 1, 2010). Records were deduplicated by PMID and titles and abstracts underwent assisted preliminary screening. Results: Three strategies yielded 96 records; after removing 17 duplicate entries, 79 unique citations were screened. Fifty-two were provisionally excluded and 27 were shortlisted for full-text eligibility verification. Key reports describe imaging differences from ruptured functional cysts, elevations of inflammatory and tumor markers, and surgical cohorts addressing recurrence and fertility. Conclusions: Ruptured endometrioma should remain in the differential diagnosis of sudden pelvic pain with an adnexal mass and free intraperitoneal fluid, while urgent exclusion of ectopic pregnancy, adnexal torsion, and uncontrolled bleeding remains essential. Final inclusion, independent verification, and quality appraisal are pending.

Keywords: Endometriosis; Ovarian cyst; Hemoperitoneum; Acute abdomen; Differential diagnosis; Literature review.