Corpus luteal cyst rupture

Changed by Derek Smith, 28 Jul 2017

Updates to Article Attributes

Body was changed:

Ruptured corpus luteal cyst is one of the commonest causes of spontaneous haemoperitoneum in a woman of reproductive age.

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 if 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 haemorrhage form an organised haematoma and a complexvascularrcomplex vascular adnexal mass
CT
  • well circumscribed cystic lesion
  • thick walled cyst (<3 mm) with inhomogenous contrast enhancement
  • high attenuation component (45-100 HU)
  • “fluid-fluid hematocrit” level
  • hemoperitoneum with free fluid near the source of bleeding having acan have high attenuation value ( 60(60-65 HU), “sentinel clot” and further the attenuation of free fluid reduces further from the source

Differential diagnosis

Possible considerations include

  • -<li>at times the entire rupture and haemorrhage form an organised haematoma and a complexvascularr adnexal mass</li>
  • +<li>at times the entire rupture and haemorrhage form an organised haematoma and a complex vascular adnexal mass</li>
  • -<li> “fluid-fluid hematocrit” level</li>
  • -<li>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</li>
  • +<li>“fluid-fluid hematocrit” level</li>
  • +<li>hemoperitoneum with free fluid near the source of bleeding can have high attenuation value (60-65 HU), “sentinel clot” and the attenuation of free fluid reduces further from the source</li>

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