Women of childbearing age presenting with hemoperitoneum of gynecological origin may have ectopic pregnancy, ruptured corpus luteum cyst, uterine rupture, endometriosis, or ruptured hydro-/pyosalpinx.

The characteristics of a ruptured corpus luteum hemorrhage are:

  • patient of child-bearing age,
  • sharp and sudden-onset pain
  • history of recent sexual intercourse or strenuous physical activity
  • a significant proportion of pregnant patients (either ectopic or intrauterine)
  • onset during the secretory phase of the menstrual cycle (days 14–30).

In the case of a ruptured corpus luteum cyst the first-choice treatment is conservative management. However, if the patient has unstable vital signs, significant hemoglobin decrease and/or increasing hemoperitoneum in follow-up sonographic examinations laparoscopy should be performed.

Our image depicts hemoperitoneum in a case of a ruptured corpus luteum cyst after sexual intercourse. Note the blood clots inside the pouch of douglas.



  • Fiaschetti V, Ricci A, Scarano AL, et al. Hemoperitoneum from Corpus Luteal Cyst Rupture: A Practical Approach in Emergency Room. Case Reports in Emergency Medicine. 2014;2014:252657. doi:10.1155/2014/252657.
  • Wen-Kuang Ho, Ya-Fen Wang, Hsin-Hung Wu, Horng-Der Tsai, Tze-Ho Chen, Ming Chen. Ruptured corpus luteum with hemoperitoneum: case characteristics and demographic changes over time. Taiwan J Obstet Gynecol. 2009 Jun; 48(2): 108–112. doi: 10.1016/S1028-4559(09)60267-9

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