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Ruptured corpus luteum with large hemoperitoneum

Case contributed by Alexandra Stanislavsky
Diagnosis certain

Presentation

Acute onset left iliac fossa pain.

Patient Data

Age: 30 years
Gender: Female
  • 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

Case Discussion

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. 

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