Endometriosis-induced massive hemoperitoneum misdiagnosed as ruptured ectopic pregnancy: a case report
Abstract Background Endometriosis, an estrogen-dependent inflammatory disease, is commonly observed in gynecologic practice. Spontaneous hemoperitoneum is a rare but serious complication of endometriosis. Most cases of endometriosis-induced hemoperitoneum are attributable to a ruptured endometrioma...
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| Format: | Article |
| Language: | English |
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BMC
2020-09-01
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| Series: | Journal of Medical Case Reports |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13256-020-02486-7 |
| _version_ | 1818503329088536576 |
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| author | Bong Hyeon Kim Seong Nam Park Byoung Ryun Kim |
| author_facet | Bong Hyeon Kim Seong Nam Park Byoung Ryun Kim |
| author_sort | Bong Hyeon Kim |
| collection | DOAJ |
| description | Abstract Background Endometriosis, an estrogen-dependent inflammatory disease, is commonly observed in gynecologic practice. Spontaneous hemoperitoneum is a rare but serious complication of endometriosis. Most cases of endometriosis-induced hemoperitoneum are attributable to a ruptured endometrioma or utero-ovarian vessel hemorrhage. We report a case of massive hemoperitoneum secondary to intra-abdominal bleeding from the peritoneal endometriotic deposits with spontaneous abortion that was misdiagnosed as a ruptured ectopic pregnancy. Case presentation A 36-year-old Korean woman was admitted to our hospital for acute abdominal pain and vaginal bleeding. She was suspected of ruptured ectopic pregnancy on the basis of a positive serum human chorionic gonadotropin test result and ultrasonographic evidence of pelvic fluid collection. During hospitalization, her symptoms deteriorated with peritoneal irritation sign on physical examination, hypotension, and tachycardia. Emergency exploratory laparoscopy was performed and revealed active bleeding from the peritoneal endometriotic deposit, which was treated with laparoscopic electrocoagulation. The patient’s postoperative course was uneventful. Spontaneous abortion was diagnosed on the basis of decreased serial serum human chorionic gonadotropin level estimation. Conclusions Although rare, gynecologists should consider endometriosis-induced hemoperitoneum with spontaneous abortion in the differential diagnosis in women of reproductive age presenting with a positive serum human chorionic gonadotropin test result and acute abdomen with intra-abdominal bleeding. |
| first_indexed | 2024-12-10T21:22:36Z |
| format | Article |
| id | doaj.art-df2c21ae2e484a3aa906448247057fe9 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-12-10T21:22:36Z |
| publishDate | 2020-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-df2c21ae2e484a3aa906448247057fe92022-12-22T01:33:05ZengBMCJournal of Medical Case Reports1752-19472020-09-011411410.1186/s13256-020-02486-7Endometriosis-induced massive hemoperitoneum misdiagnosed as ruptured ectopic pregnancy: a case reportBong Hyeon Kim0Seong Nam Park1Byoung Ryun Kim2Department of Obstetrics and Gynecology, Wonkwang University HospitalDepartment of Obstetrics and Gynecology, Wonkwang University School of MedicineDepartment of Obstetrics and Gynecology, Wonkwang University School of MedicineAbstract Background Endometriosis, an estrogen-dependent inflammatory disease, is commonly observed in gynecologic practice. Spontaneous hemoperitoneum is a rare but serious complication of endometriosis. Most cases of endometriosis-induced hemoperitoneum are attributable to a ruptured endometrioma or utero-ovarian vessel hemorrhage. We report a case of massive hemoperitoneum secondary to intra-abdominal bleeding from the peritoneal endometriotic deposits with spontaneous abortion that was misdiagnosed as a ruptured ectopic pregnancy. Case presentation A 36-year-old Korean woman was admitted to our hospital for acute abdominal pain and vaginal bleeding. She was suspected of ruptured ectopic pregnancy on the basis of a positive serum human chorionic gonadotropin test result and ultrasonographic evidence of pelvic fluid collection. During hospitalization, her symptoms deteriorated with peritoneal irritation sign on physical examination, hypotension, and tachycardia. Emergency exploratory laparoscopy was performed and revealed active bleeding from the peritoneal endometriotic deposit, which was treated with laparoscopic electrocoagulation. The patient’s postoperative course was uneventful. Spontaneous abortion was diagnosed on the basis of decreased serial serum human chorionic gonadotropin level estimation. Conclusions Although rare, gynecologists should consider endometriosis-induced hemoperitoneum with spontaneous abortion in the differential diagnosis in women of reproductive age presenting with a positive serum human chorionic gonadotropin test result and acute abdomen with intra-abdominal bleeding.http://link.springer.com/article/10.1186/s13256-020-02486-7Acute abdomenEndometriosisHemoperitoneum |
| spellingShingle | Bong Hyeon Kim Seong Nam Park Byoung Ryun Kim Endometriosis-induced massive hemoperitoneum misdiagnosed as ruptured ectopic pregnancy: a case report Journal of Medical Case Reports Acute abdomen Endometriosis Hemoperitoneum |
| title | Endometriosis-induced massive hemoperitoneum misdiagnosed as ruptured ectopic pregnancy: a case report |
| title_full | Endometriosis-induced massive hemoperitoneum misdiagnosed as ruptured ectopic pregnancy: a case report |
| title_fullStr | Endometriosis-induced massive hemoperitoneum misdiagnosed as ruptured ectopic pregnancy: a case report |
| title_full_unstemmed | Endometriosis-induced massive hemoperitoneum misdiagnosed as ruptured ectopic pregnancy: a case report |
| title_short | Endometriosis-induced massive hemoperitoneum misdiagnosed as ruptured ectopic pregnancy: a case report |
| title_sort | endometriosis induced massive hemoperitoneum misdiagnosed as ruptured ectopic pregnancy a case report |
| topic | Acute abdomen Endometriosis Hemoperitoneum |
| url | http://link.springer.com/article/10.1186/s13256-020-02486-7 |
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