Ultrasound and computed tomography diagnostics of ovarian cyst rupture with hemoperitoneum
Gulnaz K. Sadykova , Igor S. Zheleznyak , Vladimir V. Ryazanov , Ilya S. Khodkevich , Victor V. Ipatov , Anastasiya Ya. Latysheva , Mikhail Giuseppe L. Oppedisano
Russian Military Medical Academy Reports ›› 2023, Vol. 42 ›› Issue (1) : 83 -90.
Ultrasound and computed tomography diagnostics of ovarian cyst rupture with hemoperitoneum
The presented article is devoted to the issue of diagnosis of rupture of ovarian cyst complicated by hemoperitoneum. Ovarian apoplexy ranks third in the structure of urgent diseases in gynecology and second among the causes of intra-abdominal bleeding. It is a sudden hemorrhage into the ovarian tissue, accompanied by a violation of the integrity of its tissue and in some cases bleeding into the abdominal cavity, may be asymptomatic or accompanied by the sudden appearance of unilateral pain in the lower abdomen. In the conditions of emergency rest during emergency diagnostics, the main advantage of ultrasound is the ability to perform in any conditions and in any condition of the patient, therefore, this method is considered in the scientific literature as the main one for the initial examination of such patients, nevertheless, in the scientific literature there is information about the differential diagnosis of emergency gynecological conditions accompanied by hemoperitoneum by X-ray computed tomography.
The article presents the signs detected during ultrasound diagnostics and computed tomography in case of rupture of an ovarian cyst, systematized on the basis of literature data and our clinical experience. The main ultrasound and CT symptoms are intraperitoneal effusion with the presence of a “sentinel thrombus” in the injured ovary and cystic formation in the ovary.
The combined analysis of these signs will help the practitioner in an urgent situation not only to determine the blood in the abdominal cavity, but also to determine the source of bleeding, as well as to differentiate the rupture of the ovarian cyst from other conditions accompanied by acute abdominal pain syndrome.
computed tomography / hemoperitoneum / intraperitoneal effusion / ovarian apoplexy / ovarian cyst rupture / thrombotic masses / ultrasound diagnostics
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