Transvaginal ultrasound: Ruptured hemorrhagic cyst

In all three cases presented below, the patient presented with RLQ pain and reported pain when scanning over the ovary with the TVUS probe.
Image A: TVUS with power Doppler of the ovary shows a classic-appearing hemorrhagic cyst with lace-like internal echoes. Note the break in the wall (arrow) and the fluid with debris (arrowhead) adjacent to the cyst, compatible with a cyst rupture.
Image B: TVUS demonstrating small cyst with rupture. Note the normal-sized ovary (calipers), with a small follicle that has ruptured (thick arrow) with adjacent free fluid with clot (dashed arrow).
Image C: TVUS demonstrating a hemorrhagic cyst with heterogenous internal echoes. It is difficult to tell if there is a large break in the cyst wall (short arrows) or if there is blood clot seen instead of cyst wall. Note the large amount of free fluid filled with echoes compatible with blood.