Mohamed Mohamed, Al-Ramahi Ghassan, McCann Michael
Trauma Services Department, Hurley Medical Center, Flint, MI, USA
Trauma Services Department, Hurley Medical Center, Flint, MI, USA.
J Surg Case Rep. 2015 Oct 1;2015(10):rjv120. doi: 10.1093/jscr/rjv120.
Corpus luteal rupture is a common gynecologic cause for hemoperitoneum. Recent sexual intercourse is usually a preceding factor. However, postcoital hemoperitoneum without evident vaginal injury or trauma is rarely reported. We present a 34-year-old female who presented to the emergency department with severe bilateral lower quadrant abdominal pain after sexual intercourse. CT of the abdomen and pelvis revealed an intra-abdominal hematoma with extravasation of contrast questionable to be from one of the branches of the left internal iliac artery, and no adnexal abnormalities. Left internal iliac artery angiogram was performed and revealed no active extravasation. Exploratory laparotomy was performed and revealed an actively bleeding left ovarian ruptured area that was repaired and biopsied. No evidence of cysts was observed. Histopathological examination revealed a hemorrhagic corpus luteal cyst. Suspicion for corpus luteal rupture as a cause of postcoital hemoperitoneum should be maintained despite nonevidence of cysts on CT or intraoperatively.
黄体破裂是腹腔积血常见的妇科病因。近期性交通常是一个诱发因素。然而，性交后腹腔积血且无明显阴道损伤或创伤的情况鲜有报道。我们报告一例34岁女性，性交后因严重双侧下腹部疼痛就诊于急诊科。腹部和盆腔CT显示腹腔内血肿，造影剂外渗，怀疑来自左髂内动脉的一个分支，但附件无异常。进行了左髂内动脉血管造影，未发现活动性外渗。实施了剖腹探查术，发现左侧卵巢有一活动性出血的破裂区域，进行了修复和活检。未观察到囊肿迹象。组织病理学检查显示为出血性黄体囊肿。尽管CT或术中未发现囊肿迹象，但仍应怀疑黄体破裂是性交后腹腔积血的病因。
