Chocolate Cysts

A chocolate cyst, also known as an endometrioma, is a type of ovarian cyst filled with a thick, brown fluid that resembles liquid chocolate. This fluid is actually composed of old menstrual blood and endometrial tissue. When endometrial cells attach to the ovary, they form a cyst that gradually accumulates menstrual debris, leading to its characteristic dark appearance.

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Chocolate Cysts

Chocolate cysts can spread and attach to various abdominal organs, causing chronic inflammation and adhesions, which may lead to infertility. Additionally, these cysts can infiltrate the muscular layer of the uterine wall, leading to a condition called adenomyosis, which causes painful menstrual periods and abnormal uterine bleeding.

Causes of Chocolate Cysts

Currently, it is believed that chocolate cysts develop when endometrial tissue flows backward through the fallopian tubes into the abdominal cavity, where it attaches and grows. The classification of these cysts depends on the location of the growth:

Peritoneal Endometriosis
Ovarian Endometriosis
Uterine Endometriosis
Fallopian Tube Endometriosis
Renal, Bladder, or Intestinal Endometriosis

Symptoms of Chocolate Cysts

Severe menstrual pain that requires medication, with symptoms worsening over time
Abnormal or heavy menstrual bleeding, sometimes with blood clots
Abdominal, lower back, or pelvic pain, typically worsening during or around menstruation
If the cysts attach to the ovaries, a lump may be felt in the abdomen, sometimes without noticeable symptoms
In severe cases, adhesions can damage the fallopian tubes, leading to infertility. If adhesions occur near the kidneys, they may cause kidney swelling or even kidney failure
In rare cases, if endometrial tissue invades the intestines, it may result in bloody stools

Diagnosis of Chocolate Cysts or Ovarian Endometriomas

Diagnosis typically begins with taking a medical history and conducting a physical examination. If the diagnosis remains uncertain, an ultrasound may be used to visualize the abdominal organs, or an MRI may be performed for a more detailed assessment of disease severity.