Gan Lin-Wang, Li Qian-Cheng, Yu Zhao-Lan, Zhang Li-Ling, Liu Qi, Li Ying, Ou San-Tao
Department of Nephrology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China.
Department of Respiratory, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China.
World J Clin Cases. 2021 Aug 6;9(22):6510-6514. doi: 10.12998/wjcc.v9.i22.6510.
Abdominal hemorrhage is a complication of peritoneal dialysis catheter (PDC) insertion that cannot be neglected, and its causes are mainly related to surgical injury. This article reports a case of massive abdominal hemorrhage that was caused by a rare rupture of corpus luteum shortly after PDC during the initiation of peritoneal dialysis (PD) insertion.
A 37-year-old woman was surgically placed a Tenckhoff catheter because of end-stage renal disease. On the third postoperative day, the color of the abdominal drainage fluid was pink, and deepened gradually. It turned pale after initiating conservative treatment. On the tenth postoperative day, the color of the abdominal drainage fluid suddenly turned dark red, and the color progressively deepened. The patient's hemoglobin dropped from 88 g/L to 57 g/L. Abdominal computed tomography (CT) indicated abdominal effusion and a high-density shadow in the abdominal cavity. The surgeon performed a laparotomy and found that the corpus luteum had ruptured on the right side and a left ovarian blood body had formed. The gynecologist repaired the ovary and performed a bilateral oophoroplasty. After the operation, the patient stopped bleeding and hemodialysis was temporarily stopped. PD was resumed after half a month. The patient's condition improved, and she was discharged 14 d after the laparotomy.
If abdominal hemorrhage occurs in women of childbearing age after PDC insertion, luteal rupture should be considered as the cause.
腹腔内出血是腹膜透析导管（PDC）置入的一种不可忽视的并发症，其原因主要与手术损伤有关。本文报道1例腹膜透析（PD）置管开始时PDC置入后不久因罕见的黄体破裂导致大量腹腔内出血的病例。
一名37岁女性因终末期肾病接受了Tenckhoff导管置入手术。术后第3天，腹腔引流液颜色呈粉红色，并逐渐加深。开始保守治疗后颜色变浅。术后第10天，腹腔引流液颜色突然变为暗红色，且颜色逐渐加深。患者血红蛋白从88 g/L降至57 g/L。腹部计算机断层扫描（CT）显示腹腔积液及腹腔内高密度影。外科医生进行剖腹探查，发现右侧黄体破裂，左侧卵巢形成血体。妇科医生对卵巢进行了修复并实施了双侧卵巢成形术。术后患者停止出血，暂时停止血液透析。半个月后恢复PD。患者病情好转，剖腹探查术后14天出院。
育龄期女性PDC置入后若发生腹腔内出血，应考虑黄体破裂为病因。
