If it doesn't rupture spontaneously, surgery is sometimes performed to remove it. This will relieve the symptoms and prevent torsion. This surgery is done electively. Torsioned Ovarian Cyst A torsioned or twisted ovarian cyst occurs when the cyst twists on its vascular stalk, disrupting its blood supply. This problem is often indistinguishable clinically from a pelvic abscess or appendicitis, although an ultrasound scan can be helpful.
Treatment is surgery to remove the necrotic adnexa.
If surgery is unavailable, then bedrest, IV fluids and pain medication may result in a satisfactory, though prolonged, recovery. In this suboptimal, non-surgical setting, metabolic acidosis resulting from the tissue necrosis may be the most serious threat to the patient. For this reason, patients thought to have a torsioned ovarian cyst should be moved to a definitive care setting where surgery is available. Initial infections are caused by single-agent STDs, such as gonorrhea or chlamydia. Mild PID Gradual onset of mild bilateral pelvic pain with purulent vaginal discharge is the typical complaint.