Perforating Hemorrhagic (Chocolate) Cysts of the Ovary

The serious, though unusual, hemorrhage of ovarian origin into the peritoneal cavity simulating ruptured tubal pregnancy is well known to every abdominal surgeon, even though he may have encountered but few such instances in his own practice. The literature on this subject has been recently reviewed by Novak¹and by Smith.²The larger ovarian cysts, also with hemorrhagic contents due to twisting of the pedicle of the cyst or from other conditions, are so obvious as to make it impossible to overlook them. Ovarian hematomas due to various causes have been reported by Savage,³Wolf,⁴Hedley,⁵Novak⁶and others. There is, however, one type of hemorrhagic ovarian cyst or ovarian hematoma which should receive more careful attention; not only on account of its frequency but because of the nature of the adhesions resulting from the escape of its contents into the peritoneal cavity. These