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[Hypovolemic shock due to ovarian bleeding]
Thijs de Rooij1,2, Roosmarijn Luttmer3, Stella Tiersma3
1Amsterdam UMC, locatie VUmc, Amsterdam: Afd. SEH.
Background:
Ovulation may lead to abdominal pain. It is well-known that ovulation can cause intra-abdominal bleeding. However, literature on hypovolemic shock due to an ovarian bleeding is scarce.
Case Description:
A 30-year-old woman visited the emergency room because of acute pain of the lower abdomen. Her skin was pale, her vital signs were normal and a pregnancy test was negative. At presentation, her blood pressure decreased to 87/50 mmHg. Therefore, intra-abdominal bleeding was suspected and the gynecologist was consulted. On ultrasound, intraperitoneal fluid was seen, so we proceeded to emergency laparoscopy. During surgery, we found a bleeding corpus luteum (corpus rubrum) leading to 2.5 L of free intra-abdominal blood. The bleeding was stopped intraoperatively.
Conclusion:
A bleeding corpus luteum can lead to hypovolemic shock. Ovarian bleeding should be considered in case of shock combined with lower abdominal pain, ultrasound should be performed promptly and the gynecologist has to be consulted.
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