From the history and the histological findings, it can be assumed that the first event of spontaneous rupture of the epi-dermoid cyst might have occurred 4 weeks after delivery. It could have been a minor event resulting in a contained haematoma. A subsequent event after a further 4 weeks could have led to the complete rupture of the cyst, causing massive haemorrhage and leading to this patient's presentation with an acute abdomen.
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