Ruptured corpus luteum with large hemoperitoneum
Acute onset left iliac fossa pain.
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- free fluid extending into Morrison's pouch and both paracolic gutters
- thick layering of solid material with an "onion skin" appearance enveloping the left ovary and the uterus, in keeping with clotting hematoma
- prominent low resistance vessel within the left ovary
- normal right ovary
Overall appearance is of large volume hemorrhage centered on the left ovary, and this is most likely due to a ruptured corpus luteum. Findings were confirmed intraoperatively. Differential consideration in a pregnant patient would be a ruptured ectopic, however, the beta HCG was negative in this patient.