Emergency Medicine Department, Hasheminejad Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
Department of Research and Education, Razavi Hospital, Mashhad, IR Iran
Emergency Medicine Department, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
Introduction: Idiopathic thrombocytopenic purpura is a platelet autoimmune hemostatic disorder. In this study, an ITP case with abdominal signs and hemorrhagic corpus luteum is presented.
Case Presentation: The patient is a 28-year-old nonpregnant woman admitted to ED for constant acute abdominal pain, accompanied by nausea and vomiting. ITP was the prominent disease in her medical history which had been treated by corticosteroids. On physical examination, the patient had stable vital signs. Important paraclinic results were hemoglobin 8 g/dL and platelet count (7000 per microliter). Free fluid was reported in primary trans-abdominal sonography and CT scan. Finally, hemorrhagic corpus luteum was diagnosed in further radiologic studies.
Conclusions: Hemorrhagic corpus luteum is known to simulate a number of medical, surgical and gynecological conditions that cause acute abdomen. Sometimes it may have unusual presentations. Moreover, hemorrhagic corpus luteum (cysts) is not always identified during sonography and their diagnosis is often challenging as a result of variations in their size, the thickness of cyst wall, and internal echo pattern. As such, it is suggested to consider both internal and gynecologic spontaneous hemorrhages even in controlled ITP and more attention is paid to gynecologic disorders in abdominal pain management.