Hemorāģiska olnīcas cista ar hemoperitoneju kā pirmo pazīmi trombocitopēnijai: klīniskais gadījums
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Date
2021
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Ievads
Hemorāģiska olnīcas cista ir adneksāla masa, kas veidojas, ja rodas asiņošana folikulārā vai dzeltenā ķermeņa cistā, un tā ir salīdzinoši izplatīta sievietēm reproduktīvajā vecumā. Šajā klīniskajā gadījumā jaunai pacientei tika atrasta hemorāģiska olnīcas cista ar hemoperitoneju, iespējams, kā pirmo pazīmi trombocitopēnijai.
Klīniskā gadījuma apraksts
23 gadus veca sieviete tika uzņemta slimnīcā ar sūdzībām par stiprām sāpēm epigastrijā. Paciente tika izmeklēta, akūta apendicīta diagnoze tika izslēgta. Vēdera dobuma un retroperitoneālās telpas ultrasonogrāfijas izmeklējums atklāja brīvu šķidrumu mazajā iegurnī, un ginekoloģiskā ultrasonogrāfija atklāja hemorāģisku cistu labajā olnīcā. Paciente tika hospitalizēta ginekoloģijas nodaļā turpmākai terapijai un novērošanai. Sonogrāfijā tika atklāts palielināts brīvais šķidrums vēdera dobumā. Tika veiktas asins analīzes. Beta hCG bija < 0,100 mIU/l. Izmeklējot tika atklāts, ka pacientei ir trombocitopēnija (55 x 10^9/L), paciente tika ārstēta konservatīvi un sūdzības izzuda. HIV, EBV, CMV, antivielas pret trombocītiem bija negatīvas. Turklāt tika konstatēta viegla neitropēnija un anēmija. Paciente tika izrakstīta no slimnīcas ar ieteikumu veikt papildus izmeklējumus, hematologs uzstādīja diagnozi - idiopātiska trombocitopēniska purpura.
Kopsavilkums
Šis klīniskais gadījums parāda to, kā hemorāģiska olnīcas cista ar intraperitoneālu asiņošanu var būt pirmais trombocitopēnijas simptoms.
Secinājumi
Olnīcu folikula plīsums ir ļoti izplatīts labdabīgs stāvoklis reproduktīvā vecuma sievietēm. Jebkura saistīta asiņošana, visticamāk, nav nozīmīga, ja vien nav nopietna hemostātiska traucējuma un šajā gadījumā ārstēšana atšķiras. Šis klīniskais gadījums uzsver vienkāršu izmeklējumu nozīmi, kā pilnu asins ainu, pirms lēmuma pieņemšanas par operācijas veikšanu.
Introduction Hemorrhagic ovarian cyst is an adnexal mass, which is formed because of occurrence of bleeding into a follicular or corpus luteum cyst, and it is relatively common in women of reproductive age. In this case report, a hemorrhagic ovarian cyst with haemoperitoneum was found in a young patient, possibly as the first presentation of thrombocytopenia. Case Description A 23 years old woman was admitted to the hospital with complaints of severe pain in the epigastric region. The patient was examined, the diagnosis of acute appendicitis was excluded. Abdominal and retroperitoneal ultrasound revealed free fluid in pelvis, and gynecological ultrasound revealed a hemorrhagic cyst in the right ovary. The patient was hospitalized in gynecology department for therapy and monitoring. In sonography, increased free fluid in the abdominal cavity was revealed. Blood tests were performed. Beta hCG was <0.100 mIU/l. An examination revealed that the patient had thrombocytopenia (55 x 10^9/L), the patient was managed conservatively, and complaints vanished. HIV, EBV, CMV, antibodies against thrombocytes were negative. Additionally, mild neutropenia and anemia was found. The patient was discharged from the hospital with a recommendation to do further examinations, and the diagnosis of idiopathic thrombocytopenic purpura was set by a haematologist. Summary This case report shows how hemorrhagic ovarian cyst with intra-peritoneal haemorrhage may be the first symptom of thrombocytopenia. Conclusions The rupture of an ovarian follicle is a very common benign condition in women of the reproductive age group. Any associated bleeding is unlikely to be significant unless there is an underlying severe haemostatic derangement, and, in this case, the management differs. This case report emphasizes the role of simple investigations such as full blood count before making a decision to perform surgery.
Introduction Hemorrhagic ovarian cyst is an adnexal mass, which is formed because of occurrence of bleeding into a follicular or corpus luteum cyst, and it is relatively common in women of reproductive age. In this case report, a hemorrhagic ovarian cyst with haemoperitoneum was found in a young patient, possibly as the first presentation of thrombocytopenia. Case Description A 23 years old woman was admitted to the hospital with complaints of severe pain in the epigastric region. The patient was examined, the diagnosis of acute appendicitis was excluded. Abdominal and retroperitoneal ultrasound revealed free fluid in pelvis, and gynecological ultrasound revealed a hemorrhagic cyst in the right ovary. The patient was hospitalized in gynecology department for therapy and monitoring. In sonography, increased free fluid in the abdominal cavity was revealed. Blood tests were performed. Beta hCG was <0.100 mIU/l. An examination revealed that the patient had thrombocytopenia (55 x 10^9/L), the patient was managed conservatively, and complaints vanished. HIV, EBV, CMV, antibodies against thrombocytes were negative. Additionally, mild neutropenia and anemia was found. The patient was discharged from the hospital with a recommendation to do further examinations, and the diagnosis of idiopathic thrombocytopenic purpura was set by a haematologist. Summary This case report shows how hemorrhagic ovarian cyst with intra-peritoneal haemorrhage may be the first symptom of thrombocytopenia. Conclusions The rupture of an ovarian follicle is a very common benign condition in women of the reproductive age group. Any associated bleeding is unlikely to be significant unless there is an underlying severe haemostatic derangement, and, in this case, the management differs. This case report emphasizes the role of simple investigations such as full blood count before making a decision to perform surgery.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Hemorāģiska olnīcas cista, trombocitopēnija, Hemorrhagic ovarian cyst, thrombocytopenia