Hemoperitoneum following ovarian cyst rupture: CT usefulness in the diagnosis (original) (raw)

Management of hemoperitoneum due to rupture of the ovarian cyst

2021

To cite this article: Oana Denisa Balalau, Ileana Maria Conea, Nicolae Bacalbasa, Anca Silvia Dumitriu, Stana Paunica, Andrei Vasilache, Octavian Gabriel Olaru. Management of hemoperitoneum due to rupture of the ovarian cyst. J Clin Invest Surg. 2021; 6(1): 6-10. doi: 10.25083/2559.5555/6.1.2 Management of hemoperitoneum due to rupture of the ovarian cyst Oana Denisa Balalau, Ileana Maria Conea, Nicolae Bacalbasa, Anca Silvia Dumitriu, Stana Paunica, Andrei Vasilache, Octavian Gabriel Olaru

Ruptured ovarian cyst hemorrhage: the swing between conservative and surgical management

International Journal of Reproduction, Contraception, Obstetrics and Gynecology

Ruptured ovarian cyst hemorrhage is one of the causes of acute abdomen in women of reproductive age group that can be life threatening.1 There have been persistent interest in the discussion of managing ruptured ovarian cyst with or without ovulation.1–4 The dilemma of surgical versus conservative/non-surgical management always exist in such cases. It is more of a conundrum when the patient has abnormal coagulation due to either hematological disorders or as a result of anticoagulants.1,5 Commonly, indications for surgical interventions are variable and includes: if the source of the bleeding is not confirmed, if patient is hemodynamically unstable, or if there are evidence of ongoing bleeding not settling despite conservative measures in a reasonable time.1

Hemoperitoneum from Corpus Luteal Cyst Rupture: A Practical Approach in Emergency Room

Case Reports in Emergency Medicine, 2014

Corpus luteum cyst rupture with consequent hemoperitoneum is a common disorder in women in their reproductive age. This condition should be promptly recognized and treated because a delayed diagnosis may significantly reduce women’s fertility and intra-abdominal bleeding may be life-threatening. Many imaging modalities play a key role in the diagnosis of acute pelvic pain from gynecological causes. Ultrasound study (USS) is usually the first imaging technique for initial evaluation. USS is used to confirm or to exclude the presence of intraperitoneal fluid but it has some limitations in the identification of the bleeding source. Contrast-enhanced computed tomography (CT) is the imaging modality which could be used in the acute setting in order to recognize gynecological emergencies and to establish a correct management. Magnetic resonance imaging (MRI) nowadays is the most useful technique for studying the pelvis but its low availability and the long acquisition time of the images l...

Hemorrhagic ovarian cysts: Clinical and sonographic correlation with the management options

Middle East Fertility Society Journal, 2016

Background: Hemorrhagic ovarian cysts (HOCs) are commonly seen in clinical practice. Most of them disappear spontaneously with follow-up except in minority of cases in which surgical intervention is stated. Our aim in this study was to review the cases diagnosed as having HOCs in our hospital and clarify the clinical and sonographic features of both surgically and conservatively managed patients. Materials and methods: Forty-eight patients who had been diagnosed as having HOCs were enrolled in this retrospective study divided into 2 groups: the first was surgically managed after hospitalization and the other managed conservatively with follow-up. Clinical and sonographic features with management options of both groups were reviewed. Results: Out of 48 patients, 16 patients (33.3%) underwent a surgical procedure, and 32 (66.7%) managed conservatively. The two groups were comparable regarding clinical features. The sonographic features revealed that the mean volume of HOCs was 65.7 ml and the mean length of their greatest diameters was 4.8 cm. There was significant difference between both groups, as the values in surgical group were significantly greater than those in the conservative group (P < 0.05). According to the sonographic morphological pattern of HOCs, 8 cases (16.7%) showed a diffuse dense echo pattern mimicking a solid mass, 25 cases (52.1%) showed a sponge like pattern and 15 cases (31.2%) displayed a mixed cystic-solid pattern. Conclusion: Clinical, laboratory and ultrasound features of patients with HOCs can guide the gynecologists to the optimum management of such cases avoiding unnecessary surgery.

Huge hemorrhagic ovarian cyst alongside suspected ovarian torsion: a case report

Journal of Patan Academy of Health Sciences

An ovarian cyst is usually a relatively large, fluid-filled cystic structure (diameter greater than 3 cm) that originates from the surface or inside the ovary. Ovarian cysts can be simple or complex, depending on their internal material. Hemorrhagic ovarian cysts (HOCs) are commonly seen in clinical practice. Most of them resolve naturally during follow-up except in a minority of cases in which surgical intervention is needed. Ovarian torsion indicates partial or complete rotation of the ovary and a portion of the fallopian tube along its supplying vascular pedicle. It usually occurs in the reproductive age group, more on the right side (about 60%), and often presents with acute lower abdominal pain lasting for a few hours to 24 hours. It is one of the harmful conditions, hampering blood supply of ovary which may rise to overall necrosis of ovarian tissue and other difficulties, if not identified and managed in time. We present a case of a huge hemorrhagic ovarian cyst managed in th...

The likelihood ratio of sonographic findings for the diagnosis of hemorrhagic ovarian cysts

Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 2005

The purpose of this study was to quantify the likelihood ratio (LR) of specific sonographic features and experienced sonologist assessment in diagnosing a hemorrhagic ovarian cyst and to better understand the diagnostic power of sonography in making this diagnosis. Two sonologists, blinded to the patient's clinical history, independently reviewed the sonograms of 252 adnexal masses. For each mass, each sonologist recorded features using a standardized checklist, which included observations regarding the presence of fibrin strands, a retracting clot, septations, and wall irregularity. Each reviewer independently chose 1 specific conclusion from a list of possibilities that included the diagnosis of a hemorrhagic ovarian cyst. Sonographic observations and sonologist predictions were compared with pathologic findings (n = 214) or follow-up sonography (n = 38). Of the 252 masses, there were 30 hemorrhagic cysts. One sonologist correctly identified 25 hemorrhagic cysts, with 1 false-...

A case report: Co-existence of Acute Appendicitis and Ovarian Cyst Rupture

Zeugma Biological Science

A wide spectrum of differential diagnoses should be considered in the management of acute abdominal or acute pelvic pain in young women in the premenopausal period. In this case-report, an acute appendicitis case, which is observed accompanying with ovarian cyst rüptüre, was reported.

Rupture of endometriotic ovarian cyst causes acute hemoperitoneum in twin pregnancy

Fertility and Sterility, 2011

To present a case of an acute hemoperitoneum caused by a ruptured ovarian cyst in a late twin pregnancy. Case report study. Department of Obstetrics and Gynecology, Medical University of Graz, Austria. A woman with a history of surgery for endometriosis and currently pregnant with dichorionic twins after IVF presented with acute abdominal pain. Serial ultrasound assessment revealed a massive hemoperitoneum that was caused by a ruptured endometriotic ovarian cyst. Emergency laparotomy was performed. Hemostasis. Laparotomy led to operative hemostasis and preterm cesarean section of healthy twins at 27 weeks of gestation. Endometriosis occurs in about 10% of women of reproductive age and carries an infertility rate of up to 50%. Severe endometriosis used to be a rare event in patients with spontaneously conceived pregnancies. However, during the last decade, the increased use of assisted reproductive technologies has led to higher fertility rates in patients with endometriosis and to a higher incidence of multiple gestations. Therefore, the number of pregnant women with endometriosis and associated complications may rise.