ABSTRACT
Dengue viruses are transmitted to humans by infected mosquitoes, mainly Aedes aegypti and albopictus. Dengue illness is clinically characterized by sudden onset of fever, intense headache, retro orbital pain, myalgia, maculopapular rash, minor bleeding manifestations like petechial rashes, gum bleeding, and severe haemorrhagic manifestations like haematemesis, epistaxis & haemoperitoneum. Haemorrhagic manifestations can occur at any stage. Dengue shock syndrome is a dangerous complication with high mortality.1 Increased vascular permeability together with myocardial dysfunction, dehydration contributes to development of shock resulting in multi-organ failure like liver damage, neurological manifestation & corpus luteal cyst rupture. Endothelial dysfunction induced by cytokines and chemical mediators, results in shock. Corpus luteum is a functional cyst developing in luteal phase of ovarian cycle, which regresses spontaneously to corpus albicans when pregnancy does not occur. Being a thin walled vascular structure corpus luteum is prone to haemorrhage even if bleeding is usually contained inside the cyst. Ruptured functional ovarian cyst is a frequent cause of acute pelvic pain in women of reproductive age. Invariably it is self-limiting with conservative management.2 Occasionally it requires surgical intervention, when accompanied by haemodynamic instability, large haemoperitoneum, especially in disturbed coagulation profile,as in our case.Corpus luteal cyst rupture, with consequent haemoperitoneum is a rare disorder in women of reproductive age. The condition should be promptly diagnosed and treated because delayed diagnosis may significantly reduce women’s fertility and lead to intra-abdominal bleeding, which may be life threatening.3 Ruptured corpus luteal cyst in some instances causes massive intra-peritoneal bleed leading to death, especially with bleeding diathesis.4