Intra-abdominal hemorrhage due to a ruptured corpus luteum cyst in a girl with congenital afibrinogenemia

Koussi, Afroditi; Economou, Marina; Athanasiou-Metaxa, Miranda

doi:10.1007/pl00008423

Cited by 15 publications

(12 citation statements)

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“…However, recurrent episodes of intracranial hemorrhage have been reported 12,14–16. Hemoperitoneum and hemorrhagic corpus luteum following the rupture of a follicle during ovulation are other rare manifestations 13,17–20. The bleeding tendency is highly variable in afibrinogenemia (ranging between very few up to several episodes/year) even among patients with the same mutation 5,12,21.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Treatment of congenital fibrinogen deficiency: overview and recent findings

Τζιόμαλος

Vakalopoulou²,

Perifanis³

et al. 2009

VHRM

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Afibrinogenemia is a rare bleeding disorder with an estimated prevalence of 1:1,000,000. It is an autosomal recessive disease resulting from mutations in any of the 3 genes that encode the 3 polypeptide chains of fibrinogen and are located on the long arm of chromosome 4. Spontaneous bleeding, bleeding after minor trauma and excessive bleeding during interventional procedures are the principal manifestations. We review the management of afibrinogenemia. Replacement therapy is the mainstay of treatment of bleeding episodes in these patients and plasma-derived fibrinogen concentrate is the agent of choice. Cryoprecipitate and fresh frozen plasma are alternative treatments that should be used only when fibrinogen concentrate is not available. Secondary prophylactic treatment may be considered after life-threatening bleeding whereas primary prophylactic treatment is not currently recommended. We also discuss alternative treatment options and the management of surgery, pregnancy and thrombosis in these patients. The development of new tests to identify higher risk patients and of safer replacement therapy will improve the management of afibrinogenemia in the future.

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Section: Clinical Manifestationsmentioning

confidence: 99%

Treatment of congenital fibrinogen deficiency: overview and recent findings

Τζιόμαλος

Vakalopoulou²,

Perifanis³

et al. 2009

VHRM

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“…Additional etiologic factors such as anticoagulant drug treatment, deficiencies of factor VIII, X, and fibrinogen were excluded with patients' history and laboratory tests. [5][6][7][8][9] Intra-abdominal hemorrhage secondary to hemorrhagic follicle cyst is extremely rare in literature. Previously, Makipernaa and Nyman 10 reported a 14-year-old female patient with ITP and hemorrhagic follicle cyst similar to our patient.…”

Section: Discussionmentioning

confidence: 98%

An Extremely Uncommon Complication of ITP: Spontaneous Rupture of an Ovarian Follicle Cyst and Massive Intra-abdominal Bleeding

Yılmaz¹,

Demircioğlu²,

Türker³

et al. 2006

Journal of Pediatric Hematology/Oncology

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Idiopathic thrombocytopenic purpura usually presents with minor bleeding such as petechia and purpura. Rarely, life-threatening events as intracranial and intra-abdominal bleedings can be seen. We would like to present a rare case diagnosed as idiopathic thrombocytopenic purpura, presenting with abdominal pain and paleness. In this 17-year-old female patient, extensive abdominal sensitivity was revealed on physical examination and massive intra-abdominal hemorrhage secondary to distended ovarian follicle rupture was seen on ultrasonography and abdominal computed tomography. The case was treated successfully with intravenous immunoglobin, thrombocyte suspension, and pulse methylprednisolone.

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“…Non-pregnancy-related gynaecological reasons for haemoperitoneum in women include rupture of a follicle and ovulation, rupture of a haemorrhagic corpus luteum or rupture of a functional cyst (12). Functional ovarian cysts comprise follicular, corpus luteum, and theca luteal cysts.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of laparoscopic management of acute haemoperitoneum secondary to ruptured ovarian cysts in a haemodynamically unstable patient

Hackethal¹,

Ionesi-Pasacica²,

Kreis³

et al. 2010

Minimally Invasive Therapy & Allied Technologies

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Acute haemoperitoneum in patients with coagulation disorders or those under anticoagulation therapy is a diagnostic and therapeutic dilemma. Since radiological imaging is often insufficient for establishing the origin of the bleeding, a laparoscopic approach can be considered before a laparotomy is performed in haemodynamically unstable patients. A 32-year-old woman receiving coumadin therapy presented with acute lower abdominal complaints. Due to suspicion of a tubo-ovarian abscess after the initial ultrasound, a conservative treatment was administered. A routine blood count after 12 hours showed a significant reduction in haemoglobin. During the CT scan, the patient developed unstable haemodynamics. Based on deteriorating coagulation parameters, mass transfusion and stabilization of the coagulation were performed but were not successful. Therefore an interventional laparoscopy was performed and a ruptured ovarian cyst was found to be the cause of bleeding. A ruptured ovarian cyst might be the cause of an acute abdomen and haemoperitoneum in young women. Therefore cyclus anamnesis and the exclusion of other obvious reasons for acute mass bleeding, i.e. ectopic pregnancy, can justify the laparoscopic approach after stabilization of the coagulation parameters. Long-term combined oral contraceptive therapy is indispensable for the prevention of these sorts of bleeding complications.

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Intra-abdominal hemorrhage due to a ruptured corpus luteum cyst in a girl with congenital afibrinogenemia

Cited by 15 publications

References 0 publications

Treatment of congenital fibrinogen deficiency: overview and recent findings

Treatment of congenital fibrinogen deficiency: overview and recent findings

An Extremely Uncommon Complication of ITP: Spontaneous Rupture of an Ovarian Follicle Cyst and Massive Intra-abdominal Bleeding

Feasibility of laparoscopic management of acute haemoperitoneum secondary to ruptured ovarian cysts in a haemodynamically unstable patient

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