Ruptured Endometrioma with Hemoperitoneum Requiring Emergency Laparotomy: A Case Report.

Sangam Rai, Ganesh Dangal, Aruna Karki, Peru Pradhan, Ranjana Shrestha, Kabin Bhattachan, Sunita Maharajan, Srijana Bhandari, Amog Basnyat
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Abstract

Endometrioma is the localization of endometriosis in ovary which often develops as cyst. The condition can be complicated with infection, torsion and rupture leading to significant hemoperitoneum and ascites. We present here a 28-year female P2 L1 presented with the features of acute abdomen and severe anemia referred from other hospital where pain management was done. She had raised Ca-125 level, negative Urine Beta HCG and USG findings of left endometrioma with degenerating subserosal fibroid. The improvement of her general condition with analgesics was misleading however a static hematocrit level despite blood transfusion raised suspicion of ongoing pathology leading to blood loss and diagnostic paracentesis confirmed the hemoperitoneum while awaiting of CT report. She underwent Emergency Laparotomy which revealed hemoperitoneum of 2000ml and right ruptured ovarian endometrioma measuring and left ovarian cyst measuring 6x6 cm was noted. The postoperative period was uneventful. Keywords: Acute abdomen; case report; endometriosis; hemoperitoneum; ruptured endometrioma.

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子宫内膜异位症破裂伴腹腔积血,需要紧急开腹手术:病例报告。
子宫内膜异位瘤是子宫内膜异位症在卵巢的定位,通常发展为囊肿。该病可并发感染、扭转和破裂,导致大量腹腔积血和腹水。我们在此介绍一名 28 岁的 P2 L1 女性患者,她因急腹症和严重贫血从其他医院转诊过来,在那里接受了疼痛治疗。她的 Ca-125 水平升高,尿液 Beta HCG 阴性,USG 检查发现左侧子宫内膜瘤伴有退化的浆膜下肌瘤。使用镇痛药后,她的一般情况有所改善,但输血后血细胞比容仍处于静止状态,这让人怀疑是病理变化导致失血过多,诊断性腹腔穿刺证实了腹腔积血,同时正在等待CT报告。在等待 CT 报告期间,她接受了急诊腹腔镜手术,结果显示腹腔积血达 2000 毫升,右侧卵巢子宫内膜异位症破裂,左侧卵巢囊肿大小为 6x6 厘米。术后恢复顺利。关键词急腹症;病例报告;子宫内膜异位症;腹腔积血;子宫内膜瘤破裂。
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来源期刊
CiteScore
1.40
自引率
0.00%
发文量
81
审稿时长
15 weeks
期刊介绍: The journal publishes articles related to researches done in the field of biomedical sciences related to all the discipline of the medical sciences, medical education, public health, health care management, including ethical and social issues pertaining to health. The journal gives preference to clinically oriented studies over experimental and animal studies. The Journal would publish peer-reviewed original research papers, case reports, systematic reviews and meta-analysis. Editorial, Guest Editorial, Viewpoint and letter to the editor are solicited by the editorial board. Frequently Asked Questions (FAQ) regarding manuscript submission and processing at JNHRC.
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