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