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[Hemoperitoneum due to coitus without vaginal lesions]
H Brühwiler1, M D Mueller, A Schumacher
1Frauenklinik, Kantonsspital Münsterlingen.
Schweizerische Medizinische Wochenschrift
|September 2, 1995
Summary
Acute lower abdominal pain after intercourse can signal internal bleeding. A case study revealed internal bleeding from minor sacro-uterine ligament injuries, emphasizing the need to consider abdominal trauma even without external signs.
Area of Science:
- Gynecology
- Emergency Medicine
- Surgical Case Reports
Background:
- Acute lower abdominal pain following sexual intercourse is uncommon.
- Internal abdominal bleeding can present with varied symptoms.
Observation:
- A 27-year-old female experienced severe lower abdominal pain 14 hours post-coitus.
- Initial sonography revealed ascites and suspected clotted blood around the uterus.
- Diagnostic laparoscopy identified approximately 400 ml of hemoperitoneum.
Findings:
- The source of bleeding was identified as minor injuries to the left sacro-uterine ligament.
- Spontaneous hemostasis was achieved, necessitating only abdominal lavage.
- No vulvar or vaginal trauma was observed.
Implications:
- This case highlights the importance of considering intra-abdominal injuries in patients presenting with abdominal pain after sexual activity.
- Clinicians should maintain a high index of suspicion for internal trauma, even in the absence of external genital injuries.
- Prompt diagnostic evaluation, including imaging and laparoscopy, is crucial for identifying and managing such rare complications.