Chocolate Cyst

Chocolate Cyst, also known as an endometrioma, is a type of ovarian cyst. The characteristic feature of this cyst is that it contains fluid that resembles liquid chocolate. However, in reality, it is composed of endometrial tissue cells. When these cells attach to the ovary, they form a cyst that accumulates cells, as well as menstrual blood that has been accumulated for a long time and has become thick. Therefore, it appears similar to chocolate.

These chocolate cysts can spread and attach to various abdominal organs, causing chronic inflammation and adhesions. This can be one of the causes of infertility. Additionally, the 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 these cysts occur when endometrial tissue cells flow backward through the fallopian tubes and enter the abdominal cavity. They then attach and grow inside the abdominal cavity, resulting in chocolate cysts. The location where the cells attach and grow determines the classification of the cysts, which can be categorized as follows:

  • Peritoneal endometriosis
  • Ovarian endometriosis
  • Uterine endometriosis
  • Fallopian tube endometriosis
  • Renal, bladder, or intestinal endometriosis

Symptoms of Chocolate Cysts:

  • Severe and abnormal menstrual pain that requires medication, with the pain gradually worsening over time.
  • Abnormal and heavy menstrual bleeding, sometimes accompanied by blood clots.
  • Abdominal pain, lower back pain, or pelvic pain.
  • These symptoms tend to worsen during menstruation or before/after the menstrual period.
  • In cases where the chocolate cysts are attached to the ovaries, a lump may be felt in the abdomen without any apparent symptoms.
  • In severe cases, extensive adhesions may occur, or the fallopian tubes may be damaged, resulting in infertility.
  • If the adhesions occur in the area of the kidneys, it can cause kidney swelling or renal failure.
  •  In rare cases, when endometrial tissue infiltrates the intestines, it can cause bloody stools.

Diagnosis of Chocolate Cysts or Ovarian Endometriomas:

The doctor will take a medical history, perform a physical examination, and if the diagnosis is uncertain, they may conduct an ultrasound, which allows visualization of the organs in the abdominal cavity, or an MRI, which can provide a clear assessment of the severity of the disease.



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