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Hemorrhagic Ovarian Cysts in Patients on Anticoagulation Therapy: CT Findings

Objective Hemorrhage into ovarian cysts is a frequent and potentially life-threatening complication in women on chronic anticoagulation therapy. This article presents the CT findings of three surgically confirmed cases of symptomatic hemorrhagic ovarian cysts associated with anticoagulation therapy. Materials and Methods There were two cases of unruptured hemorrhagic ovarian cysts: a patient with two corpus luteum cysts of menstruation and a patient with a serous cystadenoma. Results Each mass had a rounded central region of high attenuation (76, 62, and 50 HU) representing blood that was surrounded by fluid density. The third case was a hemorrhagic corpus luteum cyst of menstruation with rupture and hemoperitoneum. Conclusion Hemorrhagic ovarian cysts should be included in the differential diagnosis of high-attenuation adnexal masses, especially in patients on anticoagulation therapy and in those with abrupt onset of pelvic pain.