Experiencing Recurrent Ovarian Cysts
I'm a 36-year-old woman dealing with multiple health challenges, including obesity and thyroid cancer. I also underwent a tubal ligation about four years ago. Back in June, I experienced my first ovarian cyst rupture, which was identified as hemorrhagic. A CT scan confirmed the presence of the cyst. Then in August, I faced a second rupture. The intensity of the pain I felt at that time was unbearable—truly the worst discomfort I’ve ever endured. It left me feeling desperate. When I consulted my OB-GYN, I was prescribed birth control pills. Unfortunately, I had to discontinue their use due to severe negative effects on my bipolar disorder, which led to significant suicidal thoughts. Although she offered an alternative, my previous experience made me hesitant to try again. Just this past Friday, I suffered yet another rupture. I chose not to visit the hospital because in the past, they merely provided pain relief and sent me home. I'm managing with the pain medication I was prescribed during the first incident. This latest rupture has brought discomfort, but thankfully, it's not as severe as the previous two. However, the ache isn't entirely subsiding like before. Usually, by the third day, I would feel much better, but now I am grappling with persistent nausea, swelling, and bloating. While I suspect this might be typical, I'm uncertain if it’s necessary to seek medical attention, especially in an emergency setting. Should I visit my doctor tomorrow, or if the situation doesn’t improve, should I head to the ER? I’m feeling quite miserable at this point.
Answers (1)
9/16/2025, 6:01:34 AM
OpenHealth AI
I'm sorry to hear that you’re dealing with recurrent ovarian cysts and the associated pain. These ruptures can cause significant discomfort and concern, particularly given your health history and current challenges.
Main Points:
- You're experiencing persistent symptoms after an ovarian cyst rupture.
- It's crucial to monitor these symptoms and determine if you need medical attention.
Explanation:
Ovarian cysts can sometimes rupture, leading to pain and other uncomfortable symptoms like nausea, bloating, and swelling. While it's common to have some discomfort after a rupture, the persistence and severity of your symptoms warrant careful monitoring. The pain you've experienced and the complications with your mental health from hormonal treatments are valid concerns.
Given your history of cyst ruptures and your current situation, here's some advice:
Next Steps:
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Symptom Monitoring: Keep a close watch on your symptoms. If your nausea, bloating, or swelling worsens or if you develop new symptoms such as severe pain, fever, chills, or fainting, it’s important to seek medical attention immediately.
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Pain Management: Continue using the pain medication prescribed to you, but make sure to follow the recommended dosage. If the pain becomes unmanageable, this could also be a sign to consult a healthcare provider.
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Hydration and Rest: Stay well-hydrated and give your body some time to recover. Light activities can help, but listen to your body and avoid overexertion.
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Consult a Doctor: Given your history and the continuous symptoms, consider scheduling a visit with your OB-GYN. It’s important to discuss your concerns about the birth control options and explore alternatives that won't negatively impact your mental health.
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Emergency Care: If your symptoms do not improve or worsen, or if you are unable to manage your pain despite medication, it’s advisable to go to the ER for further evaluation.
I understand that this situation is very distressing for you, and it’s perfectly fine to seek help to find the right management plan that suits your needs. You don’t have to endure this discomfort alone; there are options and professionals who can help support you. If you have any more questions or need more assistance, feel free to reach out.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.