Theca lutein cyst rupture - an unusual cause of acute abdomen : a case report

Abstract

A 20 year old illiterate woman who had a spontaneous first trimester abortion followed by instrumental evacuation, presented 4 days later with sudden onset of pain and distension of abdomen along with difficulty in breathing. On examination, she was tachypnoeic, icteric with tachycardia. Abdominal examination revealed guarding and rigidity along with free fluid and vague mass in lower abdomen. Gynaecological examination showed purulent discharge through os with bogginess in all fornices. USG revealed echogenic fluid with bilateral large ovarian masses containing multiple small cysts. Laparotomy was performed with a provisional diagnosis of ruptured theca leutein cysts after 24 hrs of administration of broad spectrum antibiotics. There were bilateral theca leutein cysts of more than 10X15 cm, the left of which has ruptured and the right on the verge of rupture. Bilateral partial cystectomy was performed and histopathological examination confirmed theca lutein cysts with inflammatory infiltrate.