Hemorrhagic Corpus Luteum With Generalized Abdominal Pain in Patients With Idiopathic Thrombocytopenic Purpura

Authors

1 Emergency Medicine Department, Hasheminejad Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran

2 Department of Research and Education, Razavi Hospital, Mashhad, IR Iran

3 Emergency Medicine Department, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran

Abstract

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.

Keywords

References

  1. Janz T, Hamilton G. Disorders of Hemostasis. In: Adams J BWBMDDGMLLNE, editor. Rosen’s Emergency Medicine. 8th ed. China: Mosby Elsevier; 2014. p. 1611.
  2. Al Ghafri W, Gowri V, Al-Khaduri M, Al-Shukri M. Life threatening corpus luteal hemorrhage. Gynecol. 2013;1(1):2.
  3. Tibbles C. Selected Gynecologic Disorders. In: Adams J, Barsan W, Biros M, Danzl D, Gausche-Hil M, Ling L, et al., editors. Rosen’s Emergency Medicine. 8th ed. China: Mosby Elsevier; 2014. pp. 1358–9.
  4. Kazadi Buanga J, Garces D, De La Fuente F. [Hemorrhagic corpus luteum in two phases]. Rev Fr Gynecol Obstet. 1992;87(2):85–6. [PubMed: 1570460]
  5. Sohail S. Hemorrhagic corpus luteum mimicking heterotopic pregnancy. J Coll Physicians Surg Pak. 2005;15(3):180–1. [PubMed: 15808104]
  6. Wilbur AC, Goldstein LD, Prywitch BA. Hemorrhagic ovarian cysts in patients on anticoagulation therapy: CT findings. J Comput Assist Tomogr. 1993;17(4):623–5. [PubMed: 8331234]
  7. Yamakami LY, de Araujo DB, Silva CA, Baracat EC, de Carvalho JF. Severe hemorrhagic corpus luteum complicating anticoagulation in antiphospholipid syndrome. Lupus. 2011;20(5):523–6. doi: 10.1177/0961203310383300. [PubMed: 21138983]
  8. Swire MN, Castro-Aragon I, Levine D. Various sonographic appearances of the hemorrhagic corpus luteum cyst. Ultrasound Q. 2004;20(2):45–58. [PubMed: 15480190]
  9. Stalnikowicz R. Hemorrhagic corpus luteum presenting as acute gastroenteritis. Am J Emerg Med. 2002;20(2):133. [PubMed: 11880885]
  10. Georgiev C, Boshnakova TS, Petkaneshkov A. [Combination of a rupture of a cystic hemorrhagic corpus luteum with a clinical picture of chronic exacerbated appendicitis and ovarian endocrine disorders]. Akush Ginekol (Sofiia). 1980;19(3):273–6. [PubMed: 7386786]
Razavi International Journal of Medicine
Volume 4, Issue 1
January 2016

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