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The sonographic appearance depends on whether a simple or hemorrhagic ovarian cyst ruptures, and whether the cyst has completely collapsed. Cysts may rupture during pregnancy if a very early pregnancy, this may cause diagnostic confusion with ectopic pregnancy. Rebound tenderness from the pain is possible and the hemorrhage from a cyst can rarely be severe enough to cause shock 2. It is a common cause of physiological pelvic intraperitoneal fluid. Ruptured ovarian cysts can have a variety of appearances depending on when the rupture took place, and whether the cyst is hemorrhagic or not. Treated conservatively in a premenopausal woman unless evidence of hypovolemic shock tachycardia and postural drop in blood pressure.