Corpus Luteum Cyst Rupture - US Findings and Clinical Features

PURPOSE: To describe the US findings of corpus luteum cyst rupture in order to elucidate the associated clinical features. MATERIALS AND METHODS: Twenty patients with proven corpus luteum cyst rupture were included in this study. The US findings of these patients were retrospectively analyzed in terms of the presence of designable cyst, size of the cyst, thickness and blood flow of the cyst wall, extension and echogenicity of peritoneal fluid, and involved site (right or left ovary). We also surveyed the clinical features such as the onset period according to the menstrual cycle, and the presence of suspectable cause. RESULTS: Fourteen of the 20 patients revealed designable cysts (mean diameter of 2.6 cm) with thick walled cysts (mean thickness, 4.6 mm, 2.4 -6.8 mm) and increased blood flow. Six patients didn 't reveal any cyst but only hematoma in adnexa. All patients had hemoperitoneum in the pelvic cavity, and the hemoperitoneum was extended to Morrison's pouch in 8 patients and to the subphrenic space in 6. The cysts occurred in the right adnexa in 15 patients and in the left in 5. Mean interval from the last menstrual period (LMP) was 26 days (13-44 days) and 6 of the 8 patients for whom it had been possible to obtain detailed history taking had had coitus just before the occurrence of symptom. CONCLUSION: When women who are hospitalized for acute abdomen and who are in luteal phase reveal US findings of hematoma or thick-walled cyst in adnexa and hemoperitoneum, a corpus luteum cyst rupture is highly suspected. In our case study the corpus luteum cyst rupture predominantly occurred in the right side, and the most suspectable cause was trauma such as coitus in the luteal phase.

Analysis of the association between periportal low attenuation, as seen on CT, after blunt abdominal trauma,and elevated central venous pressure1

PURPOSE: To assess the causes of periportal low attenuation, as seen on CT, in patients with blunt abdominaltrauma. MATERIALS AND METHODS: From among 812 patients who underwent abdominal CT after blunt abdominal trauma,we retrospectively analysed the findings in 124 with evidence of periportal low attenvation. Among these, hepaticinjury was noted in only 87. The presence or absence, and extent of hepatic injury, and of periportal lowattenuation, as seen on CT, were carefully evaluated. In each case, the ratio of the transverse diameter of theinferior vena cava(IVC) to the aorta at the level of the right adrenal gland provided an indirect measurement ofcentral venous pressure; for control purposes, the ratio was also obtained in 21 non-traumatic patients with noabnormal abdominal CT findings. RESULTS: Of the 87 patients with hepatic injury, 46 showed no periportal lowattenuation, and the average value of the ratio between the IVC and aorta was 1.16+/-0.12, while the remaining 41patients showed periportal low attenuation with a ratio of 1.51+/-0.21(p<0.05). In the 37 patients with periportallow attenuation but no evidence of concomitant hepatic injury, the average ratio was 1.52+/-0.25, while in 21non-traumatic patients it was 1.15+/-0.16. For resustication, all patients had received 0.5-5.0l of IV fluidtherapy before CT, and at the time of CT, were normotensive. CONCLUSION: Rapidly elevated central venous pressurefollowing massive IV infusion therapy in patients with blunt abdominal trauma can be one of the causes ofperiportal low attenuation, as seen on CT.