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Gan LW, Li QC, Yu ZL, Zhang LL, Liu Q, Li Y, Ou ST. Abdominal hemorrhage after peritoneal dialysis catheter insertion: A rare cause of luteal rupture: A case report. World J Clin Cases 2021; 9:6510-6514. [PMID: 34435019 PMCID: PMC8362553 DOI: 10.12998/wjcc.v9.i22.6510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/11/2021] [Accepted: 05/15/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Abdominal hemorrhage is a complication of peritoneal dialysis catheter (PDC) insertion that cannot be neglected, and its causes are mainly related to surgical injury. This article reports a case of massive abdominal hemorrhage that was caused by a rare rupture of corpus luteum shortly after PDC during the initiation of peritoneal dialysis (PD) insertion.
CASE SUMMARY A 37-year-old woman was surgically placed a Tenckhoff catheter because of end-stage renal disease. On the third postoperative day, the color of the abdominal drainage fluid was pink, and deepened gradually. It turned pale after initiating conservative treatment. On the tenth postoperative day, the color of the abdominal drainage fluid suddenly turned dark red, and the color progressively deepened. The patient’s hemoglobin dropped from 88 g/L to 57 g/L. Abdominal computed tomography (CT) indicated abdominal effusion and a high-density shadow in the abdominal cavity. The surgeon performed a laparotomy and found that the corpus luteum had ruptured on the right side and a left ovarian blood body had formed. The gynecologist repaired the ovary and performed a bilateral oophoroplasty. After the operation, the patient stopped bleeding and hemodialysis was temporarily stopped. PD was resumed after half a month. The patient’s condition improved, and she was discharged 14 d after the laparotomy.
CONCLUSION If abdominal hemorrhage occurs in women of childbearing age after PDC insertion, luteal rupture should be considered as the cause.
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Affiliation(s)
- Lin-Wang Gan
- Department of Nephrology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou 646000, Sichuan Province, China
| | - Qian-Cheng Li
- Department of Respiratory, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Zhao-Lan Yu
- Department of Nephrology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou 646000, Sichuan Province, China
| | - Li-Ling Zhang
- Department of Nephrology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou 646000, Sichuan Province, China
| | - Qi Liu
- Department of Nephrology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou 646000, Sichuan Province, China
| | - Ying Li
- Department of Nephrology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou 646000, Sichuan Province, China
| | - San-Tao Ou
- Department of Nephrology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou 646000, Sichuan Province, China
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Bauman R, Horvat G. MANAGEMENT OF RUPTURED CORPUS LUTEUM WITH HEMOPERITONEUM IN EARLY PREGNANCY - A CASE REPORT. Acta Clin Croat 2018; 57:785-788. [PMID: 31168219 PMCID: PMC6544092 DOI: 10.20471/acc.2018.57.04.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
- Rupture of the corpus luteum is a frequent condition in women of reproductive age. Because of abdominal pain accompanied by hemoperitoneum, ruptured corpus luteum can easily be confused with ectopic pregnancy. The management of ruptured corpus luteum depends on the symptoms and laboratory findings, and can be just observation but laparoscopy or urgent laparotomy may also be needed. Although rare, hemoperitoneum following rupture of corpus luteum in early pregnancy should always be considered in the diagnostic process. We present a patient that was admitted to our department with amenorrhea, positive ßhCG and acute abdomen. Emergency laparoscopy was performed but no ectopic pregnancy was found, just blood, coagula and a ruptured corpus luteum. The day after the surgery, intrauterine pregnancy was found on ultrasound and the pregnancy ended with term delivery.
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Affiliation(s)
| | - Gordana Horvat
- 1Rotunda IVF, Parnell Square, Dublin, Ireland; 2Department of Gynecology and Obstetrics, Sveti Duh University Hospital, Zagreb, Croatia
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Iyoshi S, Koike W, Takeda A. Superselective microcoil embolization of the vasa recta of sigmoid artery for hemorrhaging after laparoscopic adnexectomy for corpus luteum hematoma with severe adhesion. J Obstet Gynaecol Res 2018; 44:1487-1491. [PMID: 29956435 DOI: 10.1111/jog.13689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 04/27/2018] [Indexed: 11/28/2022]
Abstract
A 44-year-old multipara woman was referred because of the sudden onset of left lower abdominal pain. Corpus luteum hematoma was suspected and conservatively managed. Two days later, due to worsening of abdominal symptoms, emergency laparoscopic surgery was performed. Severe pelvic adhesion around the left ovary forming corpus luteum hematoma was identified. After adhesiolysis, which was complicated by massive bleeding, left adnexectomy was performed. Hemostasis was achieved by the coagulation of bleeding vessels, followed by spraying fibrin glue with the placement of oxidized cellulose cotton for bleeding oozing from dissected surface. Two hours after surgery, emergency computed tomography performed due to the development of hemodynamic instability demonstrated extravasation from the versa recta of the sigmoid artery. After the confirmation of hemorrhaging, superselective catheterization to the bleeding vessel followed by embolization by platinum microcoils were performed. Hemodynamic stability was immediately achieved, and the postoperative course was uneventful without manifestation of bowel ischemia.
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Affiliation(s)
- Shohei Iyoshi
- Department of Obstetrics and Gynecology, Gifu Prefectural Tajimi Hospital, Tajimi, Gifu, Japan
| | - Wataru Koike
- Diagnostic Pathology, Gifu Prefectural Tajimi Hospital, Tajimi, Gifu, Japan
| | - Akihiro Takeda
- Department of Obstetrics and Gynecology, Gifu Prefectural Tajimi Hospital, Tajimi, Gifu, Japan
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Hemoperitoneum from corpus luteal cyst rupture: a practical approach in emergency room. Case Rep Emerg Med 2014; 2014:252657. [PMID: 24987535 PMCID: PMC4058584 DOI: 10.1155/2014/252657] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 05/18/2014] [Accepted: 05/18/2014] [Indexed: 11/25/2022] Open
Abstract
Corpus luteum cyst rupture with consequent hemoperitoneum is a common disorder in women in their reproductive age. This condition should be promptly recognized and treated because a delayed diagnosis may significantly reduce women's fertility and intra-abdominal bleeding may be life-threatening. Many imaging modalities play a key role in the diagnosis of acute pelvic pain from gynecological causes. Ultrasound study (USS) is usually the first imaging technique for initial evaluation. USS is used to confirm or to exclude the presence of intraperitoneal fluid but it has some limitations in the identification of the bleeding source. Contrast-enhanced computed tomography (CT) is the imaging modality which could be used in the acute setting in order to recognize gynecological emergencies and to establish a correct management. Magnetic resonance imaging (MRI) nowadays is the most useful technique for studying the pelvis but its low availability and the long acquisition time of the images limit its usefulness in characterization of acute gynecological complications. We report a case of a young patient with hemoperitoneum from hemorrhagic corpus luteum correctly identified by transabdominal USS and contrast-enhanced CT.
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Takeda A, Hayashi S, Imoto S, Sugiyama C, Nakamura H. Pregnancy outcomes after emergent laparoscopic surgery for acute adnexal disorders at less than 10 weeks of gestation. J Obstet Gynaecol Res 2014; 40:1281-7. [DOI: 10.1111/jog.12332] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Accepted: 10/18/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Akihiro Takeda
- Department of Obstetrics and Gynecology; Gifu Prefectural Tajimi Hospital; Tajimi Gifu Japan
| | - Shotaro Hayashi
- Department of Obstetrics and Gynecology; Gifu Prefectural Tajimi Hospital; Tajimi Gifu Japan
| | - Sanae Imoto
- Department of Obstetrics and Gynecology; Gifu Prefectural Tajimi Hospital; Tajimi Gifu Japan
| | - Chisato Sugiyama
- Department of Obstetrics and Gynecology; Gifu Prefectural Tajimi Hospital; Tajimi Gifu Japan
| | - Hiromi Nakamura
- Department of Obstetrics and Gynecology; Gifu Prefectural Tajimi Hospital; Tajimi Gifu Japan
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Liumbruno GM, Bennardello F, Lattanzio A, Piccoli P, Rossetti G. Recommendations for the transfusion management of patients in the peri-operative period. II. The intra-operative period. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2011; 9:189-217. [PMID: 21527082 PMCID: PMC3096863 DOI: 10.2450/2011.0075-10] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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