English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Plus monthly

Global: Zendy Tools annual

Global: Zendy Tools monthly

Global: Zendy Free Plan

Haemoperitoneum secondary to ruptured corpus luteum is a rare complication for women of reproductive life. The differential diagnosis of hemoperitoneum includes various types of acute abdomen that usually associated with acute lower abdominal pain and swelling lower abdomen. The differential diagnosis includes ruptured ectopic pregnancy, ruptured chocolate cyst, twisted ovarian tumor, pelvic inflammatory disease and pelvic peritonitis . Ruptured hemorrhagic corpus luteum is an uncommon cause of acute abdomem. Its occurrence is unknown but is likely quite frequent and without symptoms. Most cases are self limiting; enquire only observation with abdominal pain relieved with analgesics. Some need laparoscopy or laparotomy to achieve homeostasis if the patient is haemodynamically unstable. Key word: Haemoperitoneum, Appendicitis, Ruptured Corpus luteum. Aim : The aim of this case report to reveal the presentation of hemorrhagic corpus luteum as acute abdomen which mimic acute appendicitis. Its clinical presentation, investigation, management with review of relevant literatures is discussed. Case-1: Mrs. Fatima, 25yrs old ,she consulted with a surgeon for severe lower abdominal pain, nausea and vomiting. She is married for 2.5yrs Her LMP 15days back. She menstruates regularly & never practices contraceptives. Clinical diagnosis: Acute appendicitis. Her blood report suggestive of acute appendicitis .Underwent urgent laparoscopy. After opening of abdomen, there was huge hemoperitoneum. Consulted with a gynecologist. Left ovary healthy, right ovary showed sign of recent rupture, contain yellowish tissue of corps luteum. Appendix was unremarkable. Her histopathology report was ruptured hemorrhagic corpus luteum. Case -2 : Mrs. Soma , 20 yrs old, she consulted with a surgeon for severe lower abdominal pain and nausea for 4 hours . She is married Case Report 1. Associate Professor, Dept. of Obst. & Gynae , RMCH 2. Assistant Chief Medical Officer, Bangladesh Bank Medical Centre, Dhaka 3. Assistant Professor, Dept. of Obst. & Gynae , RMCH for 14 months. Her LMP 15 days back. she took OCP for 1 year , changed to barrier method for 4 months. O/E: she was pale, anxious and restless but haemodynamically stable. Lower abdomen was severely tender. Clinical diagnosis was ascute appendicitis . Her Hb% 10.7mgm/dl, TC 1070, TPC 187000, urine R/M/E-NAD, USG – enlarged left ovary 109 cc (9.7x 8cm) , mild ascities , rt renal calculi, X-ray KUB region –NAD. Despite conservative treatment, there was no clinical improvement , Consulted with a gynaecologist, Cervical excitation test was positive and posterior fornix was full. Call for immediate laparotomy. There was huge haemopertitoneum, right ovary healthy, left ovary showed sign of recent rupture, contain yellowish tissue of corpus luteum. Appendix was unremarkable. Her histopathology report was ruptured hemorrhagic Corpus luteum. Case -3 : Jui a 14 yrs old unmarried regularly menstruating girl admitted in Rajshahi Medical College Hospital surgery ward on 14.04.09 with the complains of sever lower abdominal pain specially right iliac fossa for 4 hrs and diagnosed as a case of acute appendicitis . Then on examination she was haemedinamically stable and treated conservatively and discharged from hospital on 20.04.09 In spite of conservative treatment her symptom not relieved and on USG at 19.04.09 . she was diagnosed as a case of right adenexal mass. (Heterogeneous solid mass of size about 6.2 x 3.6 cm) and her Hb% 11.8 gm /dl, ESR32 \m in 1st hr, TC – N – 82%, L14%, E – 01 %, M03% and as her symptom not relieved, repeat scan done on 28.04.09, shows right ovarian haemorrhagic cyst and significant amount of fluid collection in POD. Then she consulted with a gynecologist & on examination she was haemodinamically stable but lower abdominal tenderness (++) , cervical excitation test was positive , posterior fornix was full. Then decision was taken for laparotomy. After opening the peritoneal cavity it was found that there is huge hemoperitoneum, left ovary is healthy, right ovary shows sign of recent rupture & yellowish tissue of corpus luteum Appendix was unremarkable and no bleeding point present, then after peritoneal toileting and giving a drain tube , tissue from ruptured site taken for histopathology & then incidental appendectomy done & abdomen was closed in layers . Her histopathology report shows ruptured haemorrhagic corpus luteum. Discussion : Haemorrhagic corpus luteum is an ovarian cyst formed by bleeding into a corpus luteum cyst. If it ruptures, then

Haemorrhagic Corpus Luteum Mimic Appendicitis