Hemoperitoneum after Ovulation in Systemic Lupus Erythematosus and Autoimmune Thrombocytopenia

Hemoperitoneum after Ovulation in Systemic Lupus Erythematosus and Autoimmune Thrombocytopenia

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Background.Three prior cases of hemoperitoneum associated with immune thrombocytopenia (ITP) have been reported in adolescents.This reports a case of hemoperitoneum after ovulation in an adult.Case.A 34-year-old nulligravida apac1/60/1/cw presented with abdominal pain after a heavy period and rebound tenderness.

Urine beta-hCG was negative, hemoglobin was 5.4, and platelet count was zero.CT revealed hemoperitoneum and contrast blush surrounding the left ovary.She was treated for newly diagnosed systemic lupus erythematosus and steroid-refractory ITP.Her platelet count and symptoms improved.

Conclusion.Hemoperitoneum after ovulation in ITP is rare; this represents the first adult case in the literature and reviews differential diagnosis of thrombocytopenia.The obstetrician/gynecologist chicago cubs earrings is part of a multidisciplinary team caring for patients with bleeding of gynecological origin and should withhold surgical intervention for hemoperitoneum when medical therapy is warranted.