An Unexpected Presentation of Haemoperitoneum in a Pregnant Woman

Abstract

In the majority of tertiary centres the Emergency Room or Assessment Unit is the gateway to the rest of the hospital. It is the location where critical decisions are formulated depending on whether a patient's condition is serious enough to warrant admission and, at times, emergency surgery. On occasion this decision can be straightforward based solely on the patient's presentation, observations, and basic investigations. This case highlights that although the decision and initial management may be apparent, often the diagnosis can be unexpected and that the diagnostic challenge is often outside the scope of a brief Emergency Room assessment. Corpus luteal cyst rupture is a common phenomenon but often not the cause of significant morbidity as it was in this case, especially in the absence of any associated risk factors.

Pregnancy-Preserving Laparoscopic Treatment of Acute Hemoperitoneum Following Lutein Cyst Rupture in Early Gestation

“…In the more recent case, after successful laparoscopic AHP treatment the pregnancy continued to term and resulted in the birth of a healthy newborn [6]. Additionally, we found one case of laparoscopically evacuated hemoperitoneum (1 L) in an early pregnancy (8 th GW) of unknown localization, with spontaneous hCG decline within 2 weeks following the surgery [16]. Because massive hemoperitoneum complicating normal pregnancy is a rare event, we have to consider experience gained from more frequent conditions involving AHP, e. g., CL rupture beyond pregnancy or ectopic pregnancy.…”