What Is a Ruptured Eardrum?

Rupture of the corpus luteum is one of the common acute abdomen in gynecology, and it occurs in young women between 14 and 30 years old.

Basic Information

Visiting department

Gynecology

Multiple groups

14 to 30 year old women

Common causes

Automatic rupture, impact on the lower abdomen, violent jumping, running, coughing, defecation, and strong impact on the lower abdomen during sexual intercourse

Common symptoms

Sudden severe pain in one side of the lower abdomen, and after a short period of time it becomes a persistent falling pain, which can be gradually reduced or exacerbated

Causes of luteal rupture

Automatic rupture

There is a small amount of bleeding in the normal corpus luteum, but if too much bleeding may increase the pressure in the corpus luteum, spontaneous corpus luteum rupture occurs. Some people believe that during lutealization of blood vessels, insufficiency, prone to capillary bleeding in the corpus luteum, resulting in rupture of the corpus luteum.

2. External force

When the abdomen is hit, and the abrupt jump, running, coughing, or defecation, the abdomen pressure suddenly rises, which can cause the mature corpus luteum to rupture. In addition, during sexual life, the female reproductive organs are dilated and congested, the corpus luteum increases in tension, and the man's rude movements, the woman's lower abdomen is strongly impacted, which can also cause the corpus luteum to rupture.

Clinical manifestations of luteal rupture

Sudden onset of sudden onset of sudden pain in one side of the lower abdomen, after a short period of time became persistent falling pain, which can be gradually reduced or worsened. Generally there is no vaginal bleeding or bleeding such as menstrual flow (external bleeding), and severe internal bleeding may have shock.

Corpus luteum examination

1. The patient has no history of menopause, and the onset is often in the middle or premenstrual period of two menstrual periods.

2. Abdominal examination has obvious tenderness and rebound pain. Those with more internal bleeding had percussive dullness.

3. Gynecological examination, the uterus is normal in size, the posterior fornix is tender, and the appendix can touch the mass with ambiguous borders, and there is tenderness.

4. Blood routine examination: white blood cells are normal or slightly higher, red blood cells and hemoglobin are decreased.

5. Puncture of vaginal posterior fornix can extract non-coagulant fluid.

6. Gynecological B-ultrasound and laparoscopy if necessary.

Luteal rupture diagnosis

Diagnosis is based on medical history, clinical manifestations, and examinations. Sudden lower abdomen pain, lower abdominal tenderness, rebound pain during the second half of menstruation, tenderness after gynecological examination, and a mass in the annex area with tenderness on one side. B-ultrasound found a hypoechoic area on one side of the appendix, and the posterior fornix punctured to extract no coagulation.

Differential diagnosis of corpus luteum rupture

Acute appendicitis

Appendicitis is a variety of factors that cause inflammatory changes in the appendix. Clinically, there are often manifestations of metastatic right lower abdominal pain, elevated body temperature, vomiting and neutropenia. There is generally no history of menopause and vaginal bleeding. No pelvic mass was found on the pelvic examination, and the vaginal posterior fornix puncture was negative. B-ultrasound showed no abnormal echo in the uterine appendage area.

2. Broken tubal pregnancy

The egg is fertilized in the ampulla of the fallopian tube, and the fertilized egg is blocked in the fallopian tube for some reason, but implants and develops in a part of the fallopian tube, and tubal pregnancy occurs. Many menopause history, the clinical appearance of sudden tear-like pain, began to spread to the whole abdomen from the lower abdomen, a small amount of bleeding in the vagina, dark red, decidual cast may be discharged. Pelvic examination showed cervical pain and rectal uterine depression with a mass. Puncture of the posterior vaginal fornix can extract non-coagulant fluid. The B-ultrasound indicated that the hypoechoic area of one side of the appendix contained a pregnancy sac.

3. Abortion

There is a history of menopause, clinical paroxysmal pain in the lower abdomen, vaginal bleeding, a small amount of onset, increased later, bright red, small blood clots or villous discharge. Pelvic examination showed no cervical pain, the cervix was slightly opened, and the uterus became enlarged and softened. Posterior vaginal fornix puncture was negative. Blood chorionic gonadotropin test was positive. B-ultrasound: pregnancy sac can be seen in the uterus.

Luteal rupture treatment

The principle of treatment is basically the same as ectopic pregnancy. There are two methods, conservative and surgical.

Conservative treatment

Some of the corpus luteum ruptures and bleeds can be closed by conservative treatment. If the diagnosis of the disease is confirmed by laparoscopy, conservative treatment. The abdominal pain and effusion disappeared as a cure.

2. Surgical treatment

Urgent onset, severe clinical symptoms, more internal bleeding or ectopic pregnancy, early surgery can reduce blood loss. The method is to stop the hemorrhage by laparotomy, and the corpus luteum often needs to be removed before suture. Hemorrhage was cleared at the same time during surgery, and fresh internal bleeding could also be autologous infusion.