Abdominal apoplexy associated with the levonorgestrel intrauterine system--case report

Abdominal apoplexy is defined as intraabdominal haemorrhage without an identifiable pathology. This life-threatening situation is hardly mentioned in the literature. The clinical tableau is non-specific. The onset can be with nausea, mild to severe abdominal pain, a palpable mass in the abdomen or flank and sings of hypovolemic shock. The approach should be resuscitation, look for a likely underlying cause and control the bleeding. The present report will describe a case of abdominal apoplexy in a patient using a levonorgestrel intrauterine system. The management and possible origins of abdominal apoplexy will be discussed.