Corpus luteal cyst rupture
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Ruptured corpus luteal cysts are one of the commonest causes of spontaneous haemoperitoneum in a woman of reproductive age.
Clinical presentation
Presentation is variable, ranging from completely asymptomatic to severe abdominal pain due to peritoneal irritation.
Pathology
The corpus luteum is a thick walled-walled cystic structure that is prone to internal haemorrhage, and sometimes peritoneal rupture.
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 ("ring of fire sign")
- at times the entire rupture and haemorrhage form an organised haematoma and a complex vascular adnexal mass
CT
- well circumscribed cystic lesion
- thick walled cyst (<3 mm) with inhomogeneous contrast enhancement
- high attenuation component (45-100 HU)
- “fluid-fluid hematocrit” level
- 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
Differential diagnosis
Possible considerations include:
- ruptured 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 cysts</strong> are one of the commonest causes of spontaneous <a href="/articles/haemoperitoneum">haemoperitoneum</a> in a woman of reproductive age.</p><h4>Clinical presentation</h4><p>Presentation is variable, ranging from completely asymptomatic to severe abdominal pain due to peritoneal irritation.</p><p><strong>Pathology</strong></p><p>The <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>Radiographic features</h4><h5>Ultrasound</h5><ul>- +<p><strong>Ruptured corpus luteal cysts</strong> are one of the commonest causes of spontaneous <a href="/articles/haemoperitoneum">haemoperitoneum</a> in a woman of reproductive age.</p><h4>Clinical presentation</h4><p>Presentation is variable, ranging from completely asymptomatic to severe abdominal pain due to peritoneal irritation.</p><p><strong>Pathology</strong></p><p>The <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>Radiographic features</h4><h5>Ultrasound</h5><ul>
Images Changes:
Image 4 CT (C+ portal venous phase) ( create )
