Sexual pleasure with ruptured corpus luteum cyst that ends in emergency room: A case report.

Rupture of corpus luteum cyst from sexual pleasure is an uncommon event that has not been reported in our environment (Africa). The patient is a 30-year-old primiparous woman who developed severe lower abdominal pain thirty minutes after sex; the pain was unrelenting despite the use of over-the-counter analgesic drugs and local herbs. Twelve hours after sex, when the problem persisted and she complained of dizziness and weakness, she was rushed to the emergency room of our facility for medical treatment. An initial diagnosis of ruptured ectopic gestation was made. She had an emergency laparotomy with repair of the ruptured cyst and blood transfusion. Incisional biopsy was taken from the cyst and pathological examination revealed a ruptured corpus luteum cyst. She did well post-surgery and was discharged to follow up in the clinic on the third day after surgery. Ruptured corpus luteum cyst from sexual pleasure is a rare event. Thus, a high index of suspicion is necessary to elicit a history of sex, which patients are often unwilling to disclose.

Posttraumatic Corpus Luteal Cyst Rupture: A Diagnostic Enigma for Massive Hemoperitoneum.

In the case of trauma, the presence of free fluid in the abdominal cavity on the focused assessment with sonography for trauma scan usually indicates the possibility of hemoperitoneum caused by injury to the abdominal organs. However, on rare occasions, isolated injuries to gynecologic organs can also result in hemoperitoneum, especially among women of reproductive age. Thus, the rupture of a corpus luteal cyst may be one of the myriad causes of massive hemoperitoneum and carries a risk of misdiagnosis for patients with trauma. In this case report, we highlight the characteristic imaging findings of a case of apoplexy of the corpus luteum cyst that presented to the emergency department as a cause of massive hemoperitoneum after blunt abdominal trauma.

Atypical Presentation of a Giant Hemorrhagic Ovarian Cyst.

Hemorrhagic ovarian cysts (HOCs) are frequently seen in reproductive age women, developing in the luteal phase of ovulatory cycles. Giant HOCs are rare, as bleeding inside a closed space causes acute pain leading to early diagnosis. Anovulation or oligoovulation is a defining feature of polycystic ovarian syndrome (PCOS), and hence, functional cysts are uncommon in PCOS patients. This report describes a young girl with PCOS and amenorrhea, presenting with a giant hemorrhagic ovarian cyst. Most hemorrhagic cysts undergo spontaneous resolution with follow-up. Our patient presented as a surgical emergency following torsion and rupture with hemoperitoneum. Torsion causes an obstruction in the blood flow leading to infarction and loss of ovarian viability. Early diagnosis and detorsion may help to preserve ovarian function.

A Case of Hemorrhagic Ovarian Cyst Rupture Necessitating Surgical Intervention.

Despite the relatively high incidence of ovarian cysts, particularly in premenopausal women, cyst rupture may on occasion present painfully and require surgical intervention to resolve. Particularly in the case of ruptured hemorrhagic ovarian cysts, resulting hemoperitoneum can create a risk of further adverse events including hypovolemic shock; proper identification and management of such cases are therefore critical. This case focuses on a 22-year-old female that presented to the emergency department (ED) with suprapubic pain in the lower left quadrant of the abdomen. Ultrasonography and computed tomography of the abdomen and pelvis revealed a ruptured hemorrhagic corpus luteum cyst of the left ovary and secondary hemoperitoneum. Patient treatment required laparoscopic left ovarian cyst wall removal, with the removal of hemoperitoneum.

Post coital hemoperitoneum: The pain of love.

Acute abdominal pain in women of reproductive age is common and frequent cause for visit to emergency department which warrants emergent evaluation. We present the case of a 23-year-old nulliparous women presenting with post-coital haemoperitoneum secondary to a ruptured corpus luteum cyst. This is a rare case demonstrating the need to elicit sexual history in patients presenting with an acute abdomen in emergency department.

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

OBJECTIVE: To evaluate the determinant pretreatment CT findings that can predict surgical intervention for patients suffering from corpus luteal cyst rupture with hemoperitoneum. MATERIALS AND METHODS: From 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. RESULTS: Comparative 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. CONCLUSION: The 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.

Ruptured Corpus Luteal Cyst: Prediction of Clinical Outcomes with CT

OBJECTIVE: To evaluate the determinant pretreatment CT findings that can predict surgical intervention for patients suffering from corpus luteal cyst rupture with hemoperitoneum. MATERIALS AND METHODS: From 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. RESULTS: Comparative 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 5.8 cm and concurrent active bleeding, the OR for surgery increased to 5.786. CONCLUSION: The 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.

Ruptured Hemorrhagic Corpus Luteum Cyst in an Undescended Ovary: A Rare Cause of Acute Abdomen.

BACKGROUND: Undescended ovaries are typically detected during infertility evaluations and are frequently associated with uterine malformations. Ruptured hemorrhagic corpus luteum cyst of an undescended ovary is an unusual cause of acute abdomen in an adolescent. CASE: A 15-year-old girl presented with right lower quadrant pain, nausea, and vomiting, and transabdominal sonography and magnetic resonance imaging of the pelvis showed a 10 cm × 5 cm sized cystic mass at the level of the pelvic brim, anterior to the psoas muscle suggestive of a retroperitoneal hemorrhagic cyst. At surgery, the uterus and left adnexa appeared normal, but the right ovary was not visible within the pelvic cavity, and the right pelvic retroperitoneum was distended. After opening the retroperitoneum and aspirating blood clots, the undescended ovary with a ruptured cyst was visualized within the retroperitoneum. Right ovarian wedge resection was performed and the right ovary was repositioned in the pelvic cavity. SUMMARY AND CONCLUSION: Rupture of a corpus luteum cyst in an undescended ovary should be included in the differential diagnosis of acute abdomen in adolescents.

Comparison on results of dual-phase enhanced CT scan and pathological diagnosis of ovarian corpus luteum cyst rupture / 中国医学装备

Objective:To compare the results of dual-phase enhanced CT scan and pathological diagnosis of ovarian corpus luteum cyst rupture.Methods: Thirty four cases of ovarian corpus luteum cyst rupture were treated in our hospital from April 2012 to April 2015 were retrospectively analyzed.Results: Among the 34 cases of patients, 28 cases before surgery CT accurate diagnosis of ovarian corpus luteum cyst, 6 cases before surgery CT did not accurately diagnose ectopic pregnancy bleeding was first diagnosed. In terms of the lesion, 22 cases of the right ovary and 12 cases were left ovary. Ruptured corpus luteum cyst diameter in 4.3-7.3cm, averaging (5.1±1.4)cm, the lack of complete cyst wall, visible break, there exists in the blood clot and the surrounding cyst; 20 cases with contrast extravasation, sheet or strip was present in high density around the cyst was the main clinical manifestations; a lot of low density liquid accumulated in the abdominal cavity; 28 cases with cystic density increased, the presence of a blood clot within the cyst was the main clinical manifestations. Surgical results were consistent with observed preoperative CT diagnosis. All patients were pathologically confirmed corpus luteum cyst rupture.Conclusion: Dual-phase enhanced CT scann has higher value in the diagnosis of ovarian corpus luteum cyst rupture bleeding, so is worthy of promotion.

Ruptured Heterotopic Tubal Pregnancy for a Patient with a History of Segmental Salpingectomy from Ectopic Pregnancy: A Case Report

Heterotopic pregnancy refers to the simultaneous development of an intrauterine pregnancy and an extrauterine pregnancy. We experienced a case of a ruptured heterotopic pregnancy for a patient with a history of a right segmental salpingectomy from an ectopic pregnancy. The 30-year-old patient with amenorrhea for six weeks complained of lower abdominal pain with hypovolemic shock. Transabdominal ultrasonography showed diffuse hemoperitoneum with a structure similar to an ectatic tube or a deformed cyst with no echogenic double ring or peripheral hypervascularity in the right adnexa and an intrauterine gestational sac. We considered a ruptured corpus luteum cyst as an ultrasonographic finding and found a ruptured tubal mass in the right salpinx and hemoperitoneum through an emergency laparotomy. We performed a right salpingectomy, and the histopathologic report confirmed ectopic pregnancy.

Sonographic findings of transvaginal color Doppler ultrasound in ectopic pregnancy.

PURPOSE: The objective of this study was to retrospectively assess whether the sonographic findings from transvaginal color Doppler ultrasound (TV-CDU) are helpful in the diagnosis of ectopic pregnancy. METHODS: Thirty-four patients who received surgery for ectopic tubal pregnancies were preoperatively evaluated using TV-CDU. The presence or absence of color vascularity within the ectopic masses was examined. The relationship between the presence or absence of blood flow in the tubal mass and the corpus luteum cyst, or the serum ß-hCG values, was evaluated. RESULTS: Color vascularity within the adnexal mass was detected in 27 of 34 (79.4%) patients with ectopic pregnancies by TV-CDU. Color vascularity within the mass was observed in 18 of 24 (75.0%) patients with a questionable adnexal mass that had no obvious gestational sac in B-mode images. Moreover, color vascularity was seen in all four patients with a serum ß-human chorionic gonadotropin (ß-hCG) value of less than 500 mIU/ml. However, it was difficult to identify the blood flow of the adnexal mass in six of the nine (66.7%) patients with a corpus luteum cyst in the ipsilateral ovary. No relationship was observed between the serum ß-hCG concentrations and the resistance indices, or the peak systolic velocity. CONCLUSIONS: The detection of color vascularity by TV-CDU in patients with an ectopic pregnancy is helpful for diagnosis, especially for patients with either a questionable adnexal mass in B-mode images or lower serum ß-hCG concentrations.