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Thursday, 24 September 2015

CASE 335: HEMOPERITONEUM, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

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WOMAN 33 YO, ACUTE   LEFT PELVIC PAIN, ULTRASOUND  EMERGENCY  SHOWED NORMAL SIZE OF UTERUS, ENDOMETRIUM  IN MIDDLE OF MENSTRUAL CYCLE, AND HAVING A LOT OF FLUID AND  BLOOD ARROUND  UTERUS TO MORRISSON'S  SPACE  OF ABDOMEN.
IT WAS A CASE OF HEMOPERITONEUM.

ULTRASOUND  DETECTED  ONE ROUND  MASS  AT LEFT  PELVIS WHICH WAS  SUSPECTED AN  OVARY CYST WITH SIZE OF 4 CM.





PUNCTION OF ABDOMEN  AT  RIGHT ILIAC FOSSA  REMOVED OLD  BLOOD.
BLOOD TESTS  WERE NORMAL  BETA HCG,  Hct   21%, NORMAL AMYLASEMIA.

MSCT  WITH CE  DETECTED  2 MASSES  BOTH 2 SIDES RIGHT AND LEFT  UTERUS; THE LEFT ONE  WAS  VERY QUICK CE ENHANCED  IN COMPARISON TO THE RIGHT  ONE  NON-CE ENHANCE.





Patient was  in admission of emergency of  surgery hospital.
After receiving of  2 units of blood transfusion, the vital status was stable.
Follow- up by  ultrasound one week later  the  blood clot  in pelvis was not rising  but not dissolved. Laparoscopic surgery  for  washer  this blood  and  detected  right ovary was normal, while  left ovary  had  ruptured one cyst but  already  stop bleeding.

Report of surgeon was rupture  of luteinic corpus  with blood loss more than 2,000 ml-- a  severe case of internal bleeding.

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