What is ovarian corpus luteum hematoma?

The corpus luteum of the ovary is a substance that appears in the ovary of a woman after ovulation. Under normal circumstances, when the corpus luteum develops to a certain extent, it will transform into a corpus albicans and then disappear. However, sometimes abnormal situations may occur, such as corpus luteum hematoma. When corpus luteum hematoma occurs, it can also cause ovarian cysts, lower abdominal pain, vaginal bleeding, etc., which people need to pay attention to. The following is a detailed introduction to the symptoms of ovarian corpus luteum hematoma.

symptom

The normal corpus luteum has a diameter of about 15 mm. It then transforms into a corpus albicans and naturally disappears during the follicular phase of the next cycle. If the amount of bleeding in the corpus luteum is large, it will form corpus luteum hematoma, also known as intraluteal bleeding or hemorrhagic corpus luteum. Corpus luteum hematoma is mostly unilateral, with a general diameter of 40mm, occasionally up to 100mm. After the corpus luteum hematoma is absorbed, it may lead to corpus luteum cyst. When a larger hematoma ruptures, intra-abdominal bleeding may occur, with severe abdominal pain, a small amount of vaginal bleeding and peritoneal irritation signs, which are difficult to distinguish from ectopic pregnancy.

1. In the early stage of corpus luteum hematoma, when there is a lot of bleeding in the cyst, it manifests as a nearly round cyst in the ovary, with thick cyst wall, rough inner wall, messy, heterogeneous and low echo inside the cyst, and diverse echo manifestations. (Sometimes nearly inhomogeneous solid echo)

2. In the middle stage of corpus luteal hematoma, the blood in the corpus luteal hematoma coagulates and is partially absorbed. The cyst wall becomes thinner and the inner wall becomes smooth. The echo inside the cyst decreases, presenting a coarse reticular and fine reticular structure. (Dense dot-like echoes can also be seen in the cyst)

3. In the late stage of corpus luteum hematoma, the cyst becomes smaller after blood is absorbed and turns into a white body. The internal echo is solid and slightly high-echo, and the boundary with the surrounding ovarian tissue is unclear. It is judged by the surrounding annular blood flow shown by color ultrasound. When the blood is completely absorbed, a corpus luteum cyst is formed, the cyst wall becomes smooth, and there is no echo inside the cyst, which is difficult to distinguish from other ovarian cysts.

4.CDFI: The color Doppler ultrasound manifestations of corpus luteum hematoma or corpus luteum cyst are characteristic. A supplying blood vessel can be seen in the medulla of the corpus luteum sac near the ovary, with radial branches extending to the corpus luteum sac wall. Color Doppler or power Doppler blood images can show a circle or half circle of blood flow signals around the corpus luteum sac.

Notice

Larger hemorrhagic corpora lutea are easily misdiagnosed as solid or mixed ovarian tumors, while smaller hemorrhagic corpora lutea are easily misdiagnosed as chocolate cysts. The key points for identification are that the cyst wall of the hemorrhagic corpus luteum is thicker and irregular, and that there are characteristic color ultrasound manifestations of ring-shaped blood signals around the cyst. Combined with the examination time of the corpus luteum during the menstrual cycle, it helps with diagnosis. Transvaginal ultrasound has a greater advantage in detecting internal bleeding. A full understanding of the characteristics of the corpus luteum is the key to diagnosis. Some cases are difficult to diagnose and should be rechecked within a short period of time. If there are obvious changes in the sonogram, it supports the diagnosis of corpus luteum hematoma.