Ovarian rupture

Ovarian rupture
[Summary]



Mature ovarian luteal foam or some reason caused packets wall damaged, bleeding, severe cases can cause massive intraperitoneal hemorrhage, which is ovarian rupture, it is follicular and luteal rupture luteal cyst rupture or two. Have, unmarried women may happen to reproductive age for the most common period.



[Diagnosis]




Ovarian typical symptoms of rupture due to the lack of diagnosis more difficult, and often occurred on the right side, and very easily confused with acute appendicitis, ectopic pregnancy and mixed easily misused. Correct diagnosis, it is asked in detail about the history of menstruation and clinical performance examination, a comprehensive analysis.

Ruptured ovarian menstrual cycle time and to a certain extent, can be used as the main basis for the diagnosis. About 80 percent of ruptured ovarian luteal or corpus luteum cyst rupture, which generally ovulation period, mostly in the menstrual cycle at the end of one week, even in the period of 120 days menstrual incidence. Follicle rupture for a few cases, and often occur in mature follicles, which in the general incidence of menstrual cycle 10 days to 18 days. General ruptured ovarian patients without a history of ovarian dysfunction, the majority of ovulation cycle. Abdominal tenderness not obvious, but a pair of pelvic tenderness is obvious consultation with menstrual history, that can be diagnosed. If after the onset of sexual intercourse, the more likely.


[Treatment]




Bed rest and strict observation, to Huoxue Quyu taking Chinese medicines, mainly for tackling tough challenges plot, plus appropriate Qingrejiedu drugs.

Excessive bleeding symptoms of shock, in critical condition, the surgery should immediately in order not to delay treatment.

Notes surgery, anesthesia and can refer their own blood transfusion tubal pregnancy chapter.

Operation principle must be to preserve ovarian function. General can see the breakdown of mouth or ovarian blood from the newly formed in the luteal outflow. Fine chain can be used catgut suture rupture mouth or enucleation corpus luteum cyst edge chain will be sutured.


[Etiology:




(1) spontaneous rupture: follicular or luteal hematoma hematoma continues to expand, the pressure increased to a certain extent that is broken. Several incentives are occurring: ① and ovarian congestive closely related, as a result of oppression reverse ovarian or uterine prolapse, long-term vaginal lavage, and other mechanical factors or pelvic inflammatory disease, acute and chronic appendicitis caused by ovarian congestive; ovarian ② functional changes, such as excessive cold and hot baths, long-term use of estrogen or progesterone can cause changes in ovarian function, or autonomic nervous system arising from the impact of ovarian function of the system over-active, causing bleeding tendency or coagulation disorder; ③ changes in the blood, menstruation ago, infectious diseases, anemia and malnutrition or other circumstances part of the damage caused platelet and blood components change, resulting in bleeding.

(B) ovarian directly or indirectly by rupture occurred outside influence, such as sexual intercourse, increase intra-abdominal pressure (forced stool, nausea, vomiting, weight lifters, etc.).


[Clinical]




No general history of irregular menstrual history, or amenorrhea, or half of the menstrual period before the mid-term morbidity, and the onset of intense, sudden abdominal pain, a short time after a sustained boom pain, and then gradually reduce or another to play. Dual may have nausea, vomiting, but not significantly. General absence of vaginal bleeding, severe bleeding can be symptoms of shock.

Physical: light, only slightly lower abdominal tenderness, a point on the right side, tenderness in the bottom of the Markov point, a lower position, is under severe abdominal tenderness Obviously, the anti-Tao Tong, but muscular rigidity phenomenon not generalized peritonitis.

Double up: Cervical give pain, two side Konglongbu have tenderness. Normal uterus, mobile Palace pain. Bleeding for a long time may feel annex areas or posterior vaginal fornix expandable full. Can sometimes touch on the increase ovarian.


[Diagnosis]




(1) acute appendicitis: ovarian rupture occurred on the right side more easily misdiagnosed as acute appendicitis. For the onset of acute appendicitis often full of upper abdominal pain or abdominal pain, Markov gradually limited to, nausea, vomiting more prominent, tenderness, and abdominal rigidity anti-Tiaotong than obvious. Double up: pain and uterine cervix give mobility are minor pain, and ovarian rupture completely contrary. Light ruptured ovarian gradually ease the symptoms of acute appendicitis and internal bleeding symptoms and signs, and in no appendicitis.

(B) ruptured tubal pregnancy or abortion: ovarian rupture easily misdiagnosed as ruptured tubal pregnancy or abortion, but if asked in detail about menstrual history, attention to the disease occurred in the time of the menstrual cycle, the general can identify. Tubal pregnancy often short-term amenorrhea history, a small amount of vaginal bleeding and recurrent abdominal pain. Obviously inconsistent with pelvic pain, the palpable mass. Others such as infertility history, and so on, all with different ovarian rupture.