Acute hemoperitoneum due to a ruptured hemorrhagic ovarian cyst in a 19-year-old female.

Ruptured hemorrhagic ovarian cyst is a potentially life-threatening condition that can lead to significant hemoperitoneum and hypovolemic shock. Imaging plays a crucial role in rapid diagnosis and guiding management. We report the case of a 19-year-old female who presented to the emergency department with acute pain in the lower left quadrant. Ultrasonography and computed tomography revealed a left hemorrhagic cyst with associated moderate hemoperitoneum. The patient underwent laparoscopic cyst wall removal and evacuation of hemoperitoneum, with subsequent uneventful recovery. This case highlights the importance of early imaging and the sentinel clot sign in guiding timely surgical intervention.