The ovary is a possible site of intra-abodminal hemorrhage and this can be massive and even fatal.


Synonym: ovarian apoplexy


Clinical features of ovarian hemorrhage:

(1) It is often associated with a ruptured corpus luteum or luteual cyst. The hemorrhage may be associated with a vascular malformation or aneurysm.

(2) Hemorrhage from the right ovary may mimic acute appendicitis.

(3) The risk of rupture of a corpus luteum may be increased during pregnancy.

(4) Hemorrhage can be significant in a patient who is anticoagulated or who has a coagulopathy (afibrinogenemia, other).

(5) The extent of bleeding can be massive, resulting in an acute abdomen.


Differential diagnosis:

(1) ectopic pregnancy

(2) ovarian torsion


Management often ranges from oophorectomy to control of a local lesion (wedge excision, luttectomy). Tanaka described non-operative management with the intra-abdominal hemorrhage eventually be absorbed on its own.


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