Clinic and ultrasound parallels of ovarian intra-abdominal bleedings in the women of reproductive age
SUMMARY CLINIC AND ULTRASOUND PARALLELS OF OVARIAN INTRA-ABDOMINAL BLEEDINGS IN WOMEN OF REPRODUCTIVE AGE O. Nazarenko Odessa National Medical University, Odessa, Ukraine. Introduction. Diagnosis of ovarian apoplexy is based on the data of clinical, laboratory and ultrasound investigations. However the criteria for selecting the optimum method of treatment are not determined for the different clinical situations. The aim of our study was to identify clinical, laboratory and ultrasound diagnostic features that allow to select among patients with ovarian apoplexy patients with intra-abdominal bleeding over 300 ml. Materials and methods. 110 women of reproductive age have been operated on by laparoscopic access because of ovarian apoplexy. The Military Medicine Clinical Center of the Southern region was the operative site, the operations were performed in 2008-2009. The patients have been divided into two groups, depending on the volume of intraperitoneal bleeding: the first group included 67 (60.9%) patients with the volume of blood in the abdomen not more than 300 ml, the second group consisted of 43 (39.1%) patients with the haemoperitoneum volume more than 300 ml. All the patients were examined sonographically. Surgical intervention was performed either immediately after the diagnosis of ovarian apoplexy assessment and the patient’s hospitalization or after conservative treatment attempts. Statistical processing of the results was performed with the software Statistica 5.5 (Stat Soft Inc., USA). Results. The study identified the clinical, laboratory and ultrasound characteristics of apoplexy patients’ with ovarian bleeding over 300 ml. The distinctive diagnostic features include: the presence of a significant pelvic ache, decreased hemoglobin ( to 100 g / l ), free liquid level rising above the bottom of the uterus on transvaginal sagittal echograms. The rating diagnostic signs of hemoperitoneum in patients with ovarian apoplexy can be used for the patients’ selection either for conservative or surgical treatment. If the amount of intra-abdominal bleeding does not exceed 300 ml a conservative treatment is recommended.
- Artykuły / Articles