Fig. 4. 26-year-old female patient visited emergency room with acute lower abdominal pain.

Patient had coitus 3 hours before symptom development.

A. Precontrast CT scan showed cystic mass and hemoperitoneum (34–53 HU) in pelvic cavity. B, C. Contrast media extravasation suggestive of active bleeding (arrows) adjacent to cystic mass was detected on portal venous phase axial scans. Two consecutive images confirmed curvilinear lesion as contrast media extravasation, and not dilated paraovarian vein in (B). Left ovary was well-demarcated and intact without active bleeding (arrowhead). D. Patient was surgically treated with right ovarian cystectomy and hematoma evacuation, and active bleeding focus was observed at right ovary (arrow), based on operation record. HU = Hounsfield unit