Abstract
Hemoperitoneum during pregnancy resulting from spontaneous rupture of adnexal torsion is a rare cause of fetal and maternal death. Presenting symptoms include severe abdominal pain, followed rapidly by maternal shock and fetal distress. It is hard to localize the adnexae in advanced pregnancy. Here, we present a case of spontaneous rupture of hemorrhagic corpus luteum cyst torsion that had not been previously diagnosed by ultrasound during term pregnancy. The patient was sent to our emergency room for sudden onset of severe low abdominal pain. Treatment consists of maintenance of adequate circulating intravascular volume and rapid surgical intervention. Preoperative diagnosis of adnexal torsion during term pregnancy is very difficult, although it is always identified during surgery.
Keywords: hemorrhagic corpus luteum, cyst torsion, term pregnancy
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References
- 1. Maschiach S, Bider D, Moran O. Adnexal torsion of hyperstimulated ovaries in pregnancies after gonadotropin therapy. Fertil Steril. 1990; 53: 76–80. [DOI] [PubMed] [Google Scholar]
- 2. Gordon J, Hopkins K, Jeffrey R, Giudice LC. Adnexal torsion: color Doppler diagnosis and laparoscopic treatment. Fertil Steril. 1994; 61: 383–385. [DOI] [PubMed] [Google Scholar]
- 3. Mancuso A, Broccio G, Angio L. Adnexal torsion in pregnancy. Acta Obstet Gynecol Scand. 1997; 76: 83–84. [DOI] [PubMed] [Google Scholar]
- 4. Hibbard LT. Adnexal torsion. Am J Obstet Gynecol. 1985; 152: 456–461. [DOI] [PubMed] [Google Scholar]
- 5. Lee CH, Raman S, Sivanesaratnam V. Torsion of ovarian tumors: a clinicopathologic study. Int J Gynecol Obstet. 1989; 28: 21–25. [DOI] [PubMed] [Google Scholar]
- 6. Shalev E, Peleg D. Laparoscopic treatment of adnexal torsion. Surg Gynecol Obstet. 1993; 176: 448–450. [PubMed] [Google Scholar]
- 7. Zweizig S, Perron J, Grubb D, et al. Conservative management of adnexal torsion. Am J Obstet Gynecol. 1993; 168: 1791–1795. [DOI] [PubMed] [Google Scholar]
- 8. Oelsner G, Bider D, Goldenberg M, et al. Long‐term follow‐up of the twisted ischemic adnexa managed by detorsion. Fertil Steril. 1993; 60: 976–979. [DOI] [PubMed] [Google Scholar]
- 9. Chapron C, Capella‐Allouc S, Dubuisson JB. Treatment of adnexal torsion using operative laparotomy. Hum Reprod. 1996; 11: 998–1003. [DOI] [PubMed] [Google Scholar]
- 10. Baker TE, Copas PR. Adnexal torsion: a clinical dilemma. J Reprod Med. 1995; 40: 447–449. [PubMed] [Google Scholar]
- 11. Morice P, Louis‐Sylvestre C, Chapron C, Dubuission JB. Laparoscopy for adnexal torsion in pregnant women. J Reprod Med. 1997; 42: 435–439. [PubMed] [Google Scholar]
- 12. Bromley B, Benaceraf B. Adnexal mass during pregnancy: accuracy of sonographic diagnosis and outcome. J Ultrasound Med. 1997; 16: 447–452. [DOI] [PubMed] [Google Scholar]
- 13. Minor MR, Livolsi VA. Massive edema of the ovary. Am J Dis Child. 1997; 131: 1295–1298. [DOI] [PubMed] [Google Scholar]
- 14. Hinshaw DB, Kugel AI. Torsion and infarction of the normal ovary: a cause of the acute abdomen. Am J Dis Child. 1956; 92: 57–59. [DOI] [PubMed] [Google Scholar]
- 15. Nissen ED, Kent DR, Nissen SE, Feldman BM. Unilateral tuboovarian autoamputation. J Reprod Med. 1997; 19: 151–153. [PubMed] [Google Scholar]
- 16. Bider D, Mashiach S, Dulitzky M, et al. Clinical, surgical and pathologic finding of adnexal torsion in pregnant and non‐pregnant women. Surg Gynecol Obstet. 1991; 173: 363–366. [PubMed] [Google Scholar]
- 17. Nelson MJ, Cavalieri R, Graham D. Cysts in pregnancy discovered by sonography. J Clin Ultrasound. 1986; 14: 509–512. [DOI] [PubMed] [Google Scholar]
- 18. Hogston P, Lilford RJ. Ultrasound study of ovarian cysts in pregnancy: prevalence and significance. Br J Obstet Gynaecol. 1986; 93: 625–628. [DOI] [PubMed] [Google Scholar]
- 19. Vierhout ME, Wallenburg HC. Torsion of the fallopian tube: a case report of a bilateral non‐simultaneous torsion and a review of the literature. Eur J Obstet Gynecol Reprod Biol. 1986; 23: 111–115. [DOI] [PubMed] [Google Scholar]
- 20. Hodgkins CP, Christiansen RS. Hemorrhage from ruptured utero‐ovarian veins during pregnancy. Am J Obstet Gynecol. 1950; 59: 1112–1116. [DOI] [PubMed] [Google Scholar]