Presentation
RIF pain. Last menstrual period approximately one month ago. Regular periods. No oral contraceptive or hormonal treatment.
Patient Data
Transabdominal and transvaginal examination.
The uterus is of normal appearance and anteverted. It was mobile and non-tender during the examination. The myometrium is of homogenous attenuation, but there 2 small focal lesions in the anterior aspect, measuring 20 and 13 mm, most in keeping with fibroids. The endometrial thickness is 12 mm and in keeping with secretory phase.
The left ovary is not identified. The right ovary measures 18 cc in total volume and contains 12 follicles. There is a 2.6 cm x 3.3 cm focal structure within the right ovary with a ring of fire color Doppler signal surrounding it and cystic spaces containing low-level echoes. The appearances are in keeping with a hemorrhagic corpus luteum cyst.
Conclusion:
Appearances and in keeping with a hemorrhagic right corpus luteum.
Case Discussion
The ring of fire sign is useful to help identify the corpus luteum, which often can be hemorrhagic. Rarely, hemorrhage from a corpus luteum can be extensive resulting in hemoperitoneum.
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