Corpus luteal cyst rupture
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Ruptured corpus luteal cyst is one of the commonest causes of spontaneous hemoperitoneumhaemoperitoneum in a woman of reproductive age group female.
Pathology
Corpus luteum is a thick walled cystic structure that is prone to internal haemorrhage, and sometimes peritoneal rupture.
Clinical features
- asymptomatic
- severe abdominal pain
- peritoneal irritation
- delayed menstrual cycle
may be thereif concomitant with pregnancy
Radiographic features
Ultrasound
- complex adnexal cyst
- rim of increased echogenicity surrounding a cystic component
- free fluid with areas of increased echogenicity representing hemoperitoneum
- on Doppler, peripheral vascularity may be seen
- at times the entire rupture and
hemorrhagehaemorrhage form an organised haematoma and acomplex avasuclarcomplexvascularr adnexal mass
CT
- well circumscribed cystic lesion
- thick walled cyst (<
;3mm;3 mm) with inhomogenous contrast enhancement - high attenuation component (45-100
HUHU) - “fluid-fluid hematocrit” level
- hemoperitoneum with free fluid near the source of bleeding having a high attenuation value ( 60-65 HU), “sentinel clot” and further the attenuation of free fluid reduces
Differential diagnosis
Possible considerations include
-
ruptureruptured ectopic pregnancy: evaluation of serum βhCG-levels is necessary to differentiate ruptured corpus luteal cyst from ruptured ectopic pregnancy, which may have a similar presentation - ruptured ovarian cyst: no haemoperitoneum
-<p><strong>Ruptured corpus luteal cyst</strong> is one of the commonest causes of spontaneous hemoperitoneum in a reproductive age group female.</p><h4>Pathology</h4><p><a href="/articles/corpus-luteum">Corpus luteum</a> is a thick walled cystic structure that is prone to internal haemorrhage, and sometimes peritoneal rupture. </p><h4>Clinical features</h4><ul>- +<p><strong>Ruptured corpus luteal cyst</strong> is one of the commonest causes of spontaneous haemoperitoneum in a woman of reproductive age.</p><h4>Pathology</h4><p><a href="/articles/corpus-luteum">Corpus luteum</a> is a thick walled cystic structure that is prone to internal haemorrhage, and sometimes peritoneal rupture. </p><h4>Clinical features</h4><ul>
-<li>delayed menstrual cycle may be there if concomitant with pregnancy</li>- +<li>delayed menstrual cycle if concomitant with pregnancy</li>
-<li>at times the entire rupture and hemorrhage form an organised haematoma and a complex avasuclar adnexal mass</li>- +<li>at times the entire rupture and haemorrhage form an organised haematoma and a complexvascularr adnexal mass</li>
-<li>thick walled cyst (<3mm) with inhomogenous contrast enhancement</li>-<li>high attenuation component (45-100 HU)</li>- +<li>thick walled cyst (<3 mm) with inhomogenous contrast enhancement</li>
- +<li>high attenuation component (45-100 HU)</li>
-<li>rupture <a href="/articles/ectopic-pregnancy">ectopic pregnancy</a>: evaluation of <a href="/articles/beta-hcg-1">serum βhCG</a>-levels is necessary to differentiate ruptured corpus luteal cyst from ruptured ectopic pregnancy, which may have a similar presentation </li>- +<li>ruptured <a href="/articles/ectopic-pregnancy">ectopic pregnancy</a>: evaluation of <a href="/articles/beta-hcg-1">serum βhCG</a>-levels is necessary to differentiate ruptured corpus luteal cyst from ruptured ectopic pregnancy, which may have a similar presentation </li>
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Image 2 Ultrasound (Transverse) ( create )
