Presentation
Acute severe pelvic pain.
Patient Data
A large hemoperitoneum is noted, with large blood clots seen around the right ovary and within the Douglas pouch.
The left ovary shows a small hemorrhagic cyst showing an internal blood clot and showing mild marginal post-contrast enhancement.
The right ovary shows a large simple cyst showing fine non enhancing internal septae and marginal post-contrast enhancement. The right ovary is surrounded by large blood clots encasing it.
Case Discussion
Common gynecological causes of hemoperitoneum are ruptured ovarian cyst and ruptured ectopic pregnancy. Both possibilities were considered in our case, yet the first possibility was more considered, this was later confirmed by a negative beta-HCG test.
The right ovary is surrounded by a large blood clot, which is suspicious of cyst rupture and hemoperitoneum. The left ovary also demonstrated a small hemorrhagic cyst.
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