Ruptured Corpus Luteal Cyst Research Articles

Case Report of Warfarin Induced Hemoperitoneum

Although spontaneous hemoperitoneum is a rare condition, it has the potential to be devastating. A common coumarin anti-coagulant used for therapeutic and preventive anticoagulation is warfarin. Despite being a drug that can save lives, it is linked to severe side effects, mainly bleeding. The aim and objective of the study include the unusual occurrence of Hemoperitoneum that an Anti-Coagulant Drug Warfarin induces. Although reports of spontaneous hemoperitoneum in anticoagulant-using individuals have been published in the literature, diagnostic standards and therapeutic approaches have not yet been firmly established. PT INR should be routinely checked when warfarin is prescribed to prevent any problems. Intraabdominal bleeding resulting from non-traumatic reasons or organ rupture within the abdomen is known as spontaneous hemoperitoneum. The presence of intra-abdominal bleeding from a non-traumatic origin is known as spontaneous hemoperitoneum. Hemoperitoneum from warfarin is a known side effect that can be fatal. It might be challenging to manage unexpected bleeding while keeping the INR under control and preventing thrombosis. If the INR is out of range, there is a higher risk of warfarin-induced bleeding. The spontaneous hemoperitoneum described in this case report was caused by warfarin over-toxicity in a patient with rheumatic heart disease. The indications and symptoms resemble a ruptured corpus luteal cyst or an ectopic pregnancy. Although the patients undergoing Anti-coagulant therapy, especially warfarin, may experience other symptoms like GI bleeding, Nausea, Hematuria and so on.

Complications of Haemoperitoneum due to Sexual Encounter in Pregnancy: A Case Study

Haemoperitoneum secondary to a rupture of tortuous vessels from the serosal surface of the right uterine fundal region after coitus is a rare but life-threatening condition. This case demonstrates that even a very rare diagnosis should be considered, especially when dealing with patients with atypical presentations. This case report evidences a 31-year-old woman in her first pregnancy, presenting to our hospital triage at night for abdominal pain after sexual intercourse at a gestational age of 33 weeks and 4 days, and there was no history suggestive of endometriosis or fibroids. Apart from mild pain and slight pallor, she was stable. Her initial CTG was normal, but we noted two unprovoked decelerations about 8 and 10 hours after admission. During the morning rounds review, intra-abdominal bleeding was highly suspected and an emergency caesarean section was arranged. The on-call surgeon was also alerted, and a class I caesarean section was performed through the midline sub-umbilical incision. About 800 ml of intraoperative hemoperitoneum was noted upon opening the peritoneum. A male infant weighing 2.3 kg was delivered. Clear liquor was noted. Meanwhile, a small defect of about 1 cm in diameter with active bleeding from the underlying tortuous vessel was noted over the right posterior wall of the fundus. The underlying myometrium was intact and there was neither through nor through tear nor perforation. Discussion: The precise mechanism for postcoital haemoperitoneum due to rupture of uterine subserosal vessels is not known, but it is hypothesized that: pregnancy-with the increased friability of the tissues and fixation of the genital tract coincident with gestation; vigorous intercourse; coital positions; vaginismus and genital disproportion are the possible explanations. A complete gynaecological history, including endometriosis, fibroids, pelvic inflammatory disease, and any recent surgical procedures, is required to make a diagnosis. Ruptured ectopic pregnancy and ruptured corpus luteal cyst are on the top of the list of diagnoses in the early stage of pregnancy. The majority of such cases do not voluntarily admit the preceding act of coitus during initial presentation, and care must be taken to elicit a detailed sexual history. Interestingly, spontaneous haemoperitoneum in pregnancy complicated by endometriosis may occur during pregnancy. Conclusion: The study concludes that pregnant women with a history of the recent coitus present with acute abdominal pain, even in the absence of vaginal bleeding, haemoperitoneum has to be considered. On the other hand, idiopathic or spontaneous bleeding should be kept in mind even if there is no possible explanation.

MASSIVE HAEMOPERITONIUM FROM A RUPTURED CORPUS LUTEAL CYST

A ruptured functional ovarian cyst can be a frequent cause of acute pelvic pain in women of reproductive age. The disease course varies from no symptoms or signs to severe peritoneal irritations and even life-threatening shock (1). Women of reproductive age are at risk of ruptured corpus luteum with hemoperitoneum. Prompt recognition and treatment is required for this condition because late diagnosis can be life threating for the patient. This case we are going to discuss , a 26 years married women, Para- 2 Live- 2,presented to the emergency room with acute pelvic pain. Right adnexal mass massive haemoperitonium was found on USG and CT abdomen. Emergency laparotomy was performed and proceeded with right salphingo -oophorectomy.Histopathological examination revealed right ruptured haemorrhagic corpus luteal cyst (functional cyst) to be the cause for massive haemoperitonium. Ruptured corpus luteal cyst can be a differential diagnosis for acute abdominal pain in women of reproductive age group.

Massive Hemoperitoneum from a Ruptured Corpus Luteal Cyst

Massive Hemoperitoneum from a Ruptured Corpus Luteal Cyst

Hemoperitoneum from Spontaneous Rupture of Corpus Luteal Cyst: A Case Report and Literature Review

Hemoperitoneum resulting from various gynecological emergencies can be life threatening and ruptured corpus luteal cyst is one of the causes Here we are reporting a case of yrs women with history acute pain abdomen on th day of her mentstrual cycle Ultrasound showed collection in pelvic cavity mainly around right adnexa After few hours of observation she was taken for laparotomy because of tense and tender abdomen Intraoperative there was hemoperitoneum of around cc with ruptured corpus luteal cyst of right ovary Ruptured corpus luteum cyst should be kept in differential diagnosis of acute abdomen in women of reproductive age group especially in secretory phase Timely diagnosis and management can save patient life

EP25.05: Sonographic markers in treatment of hemoperitoneum caused by corpus luteal cyst rupture

To know considerable factors to make decisions such as surgical intervention or conservative treatment in patients of hemoperitoneum, corpus luteal cyst rupture. We conducted a retrospective review of the patients diagnosed hemoperitoneum with ruptured corpus luteal cyst in Kyungpook National University Hospital in Daegu, South Korea between January 2010 and March 2015. We divided into two groups, surgical intervention or conservative treatment, compare with clinical characteristics, vital signs, laboratory tests and sonographic findings at initial visit in both groups. A total of 99 women were enrolled in our study. 78(78.8%) women were treated conservatively and 21(21.2%) women were needed surgical interventions. In two groups, there are statistically differences in initial pulse rate (p=0.027), hemoglobin (p=0.026), the amount of posterior cul-de-sac fluid (p=0.001), total cul-de-sac fluid (p=0.001), liver dome fluid (p=0.006), estimated fluid amount (p=0.001) at sonographically. In multiple logistic regression analysis, the most important risk factor to make surgical treatment is liver dome fluid collection(OR 1.2 with 95% CI, 1.111-1.202) Sonographic finding such as subhepatic fluid collection is helpful in making decision of treatment in corpus luteal cyst rupture. EP25.05: Table 1. Characteristics and sonographic findings

Ruptured Corpus Luteal Cyst: Prediction of Clinical Outcomes with CT.

ObjectiveTo evaluate the determinant pretreatment CT findings that can predict surgical intervention for patients suffering from corpus luteal cyst rupture with hemoperitoneum.Materials and MethodsFrom January 2009 to December 2014, a total of 106 female patients (mean age, 26.1 years; range, 17–44 years) who visited the emergency room of our institute for acute abdominal pain and were subsequently diagnosed with ruptured corpus luteal cyst with hemoperitoneum were included in the retrospective study. The analysis of CT findings included cyst size, cyst shape, sentinel clot sign, ring of fire sign, hemoperitoneum depth, active bleeding in portal phase and attenuation of hemoperitoneum. The comparison of CT findings between the surgery and conservative management groups was performed with the Mann-Whitney U test or chi-square test. Logistic regression analysis was used to determine significant CT findings in predicting surgical intervention for a ruptured cyst.ResultsComparative analysis revealed that the presence of active bleeding and the hemoperitoneum depth were significantly different between the surgery and conservative management groups and were confirmed as significant CT findings for predicting surgery, with adjusted odds ratio (ORs) of 3.773 and 1.318, respectively (p < 0.01). On the receiver-operating characteristic curve analysis for hemoperitoneum depth, the optimal cut-off value was 5.8 cm with 73.7% sensitivity and 58.6% specificity (Az = 0.711, p = 0.004). In cases with a hemoperitoneum depth > 5.8 cm and concurrent active bleeding, the OR for surgery increased to 5.786.ConclusionThe presence of active bleeding and the hemoperitoneum depth on a pretreatment CT scan can be predictive warning signs of surgery for a patient with a ruptured corpus luteal cyst with hemoperitoneum.

Severe acute pancreatitis in pregnancy.

This is a case of a pregnant lady at 8 weeks of gestation, who presented with acute abdomen. She was initially diagnosed with ruptured ectopic pregnancy and ruptured corpus luteal cyst as the differential diagnosis. However she then, was finally diagnosed as acute hemorrhagic pancreatitis with spontaneous complete miscarriage. This is followed by review of literature on this topic. Acute pancreatitis in pregnancy is not uncommon. The emphasis on high index of suspicion of acute pancreatitis in women who presented with acute abdomen in pregnancy is highlighted. Early diagnosis and good supportive care by multidisciplinary team are crucial to ensure good maternal and fetal outcomes.

Pregnancy outcomes after emergent laparoscopic surgery for acute adnexal disorders at less than 10 weeks of gestation

To report our experience with pregnancy outcomes after emergent laparoscopic surgery for acute adnexal disorders at less than 10 weeks of gestation when surgical intervention could be more invasive to intrauterine pregnancy. Gasless multiport laparoscopic surgery or transumbilical laparoendoscopic single-site surgery was performed with securing of the surgical view by the abdominal wall-lift method. Intraoperative autologous blood salvage and donation was performed in cases associated with significant hemoperitoneum. Six cases of ovarian bleeding with ruptured corpus luteal cyst, three cases of adnexal torsion with corpus luteal cyst, and one case each of ruptured heterotopic ampullary pregnancy and heterotopic tubal stump isthmic pregnancy after salpingectomy were managed. For ruptured corpus luteal cyst, hemostasis was achieved by removal of hematoma followed by suturing. For adnexal torsion, detorsion with cyst aspiration was performed in two cases and detorsion alone was performed in one case. For ruptured heterotopic ampullary pregnancy, unilateral salpingectomy was performed. For ruptured heterotopic tubal stump isthmic pregnancy after salpingectomy, removal of the expelled villous tissue followed by hemostatic coagulation was performed. In five cases associated with massive hemoperitoneum, intraoperative autologous blood salvage and donation were performed to avoid homologous blood transfusion. After surgery, seven live births were achieved, while two cases of biochemical pregnancy loss and a case of complete miscarriage were noted. Although miscarriage could be a significant concern in the perioperative period, gasless laparoscopic surgery appeared to be feasible for management of acute adnexal disorders at less than 10 weeks of gestation.

A primary ovarian pregnancy with a contralateral ruptured corpus luteum: a case report.

A primary ovarian pregnancy is one of the rarest varieties of ectopic pregnancies. The conditions which are most commonly confused with an ovarian pregnancy are, a ruptured corpus luteal cyst, a haemorrhagic corpus luteum and a ruptured endometriotic cyst. This case presents the clinical and the histological findings of a ruptured ovarian pregnancy, along with a ruptured corpus luteal cyst in the contralateral ovary.

Ruptured corpus luteal cyst: CT findings.

ObjectiveTo evaluate the CT findings of ruptured corpus luteal cysts.Materials and MethodsSix patients with a surgically proven ruptured corpus luteal cyst were included in this series. The prospective CT findings were retrospectively analyzed in terms of the size and shape of the cyst, the thickness and enhancement pattern of its wall, the attenuation of its contents, and peritoneal fluid.ResultsThe mean diameter of the cysts was 2.8 (range, 1.5-4.8) cm; three were round and three were oval. The mean thickness of the cyst wall was 4.7 (range, 1-10) mm; in all six cases it showed strong enhancement, and in three was discontinuous. In five of six cases, the cystic contents showed high attenuation. Peritoneal fluid was present in all cases, and its attenuation was higher, especially around the uterus and adnexa, than that of urine present in the bladder.ConclusionIn a woman in whom CT reveals the presence of an ovarian cyst with an enhancing rim and highly attenuated contents, as well as highly attenuated peritoneal fluid, a ruptured corpus luteal cyst should be suspected. Other possible evidence of this is focal interruption of the cyst wall and the presence of peritoneal fluid around the adnexa.

The acute abdomen in female children.

SummaryThe findings based on a study of 734 girls between two and 15 years of age who were seen with a suspected acute surgical abdomen have been reviewed. Two hundred twenty‐seven (31 percent) were not thought to have a surgical lesion and were not operated upon. Five hundred seven were submitted to surgery, and in 120 (23 percent of those operated upon) either no definite diagnosis was made or a nonsurgical condition was found. The most significant nonsurgical lesions giving rise to the clinical features of an acute surgical abdomen were mesenteric lymphadenitis, acute gastroenteritis, the redundant sigmoid syndrome, acute pyelonephritis, and pneumonia. In most instances the diagnosis of these conditions was made on clinical grounds, but on some occasions exploration was necessary because the signs were so strongly suggestive of a localized inflammatory or obstructive lesion.Acute appendicitis was by far the most common surgical lesion causing abdominal pain. Two hundred ninety‐seven girls suffered from this disease. Under the age of six years, the incidence of perforation was 63 percent. The overall incidence was 24 percent.Next to acute appendicitis, gynecological lesions were the most common ones to present the features of an acute abdomen in girls between 11 and 15 years of age. They accounted for the clinical features of an acute abdomen in almost 10 percent of this age group. A ruptured graafian follicle was the most common lesion followed by torsion of the ovary, ruptured corpus luteal cyst, torsion of a parovarian cyst, tubovarian abscess, and reflux of menstrual blood. Intestinal obstruction was the cause of the acute abdomen in 30 girls. Between two and four years the commonest cause was an intussusception, but after four years of age it was a postoperative adhesion. A diagnosis of primary peritonitis was made in 23 girls. In only one was a positive bacterial culture obtained from the peritoneal fluid. It would appear that a virus may well be responsible for this clinical entity. Gall bladder disease and perforated peptic ulcers accounted together for 0.5 percent of the girls seen between two and 15 years. Trauma was a rare cause and accounted for the clinical features in only two cases.Under the age of two years the features of the acute abdomen were due to intestinal obstruction in over 90 percent of girls. In the neonatal period signs of obstruction, and not pain, predominated.