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Apoplexy of ovaries


Ovary apoplexy (rupture of an ovary) – the sudden rupture (integrity disturbance) of ovary tissue which is followed by bleeding in an abdominal cavity and a pain syndrome.

In ovaries of the puberal woman there is a growth of follicles, maturing in them of an ovum, that is preparation for the forthcoming pregnancy. Since the beginning of a menstrual cycle the dominant follicle which to the middle of a menstrual cycle reaches the maximum size - about 20 mm begins to grow. Then the cover of a follicle is broken off, releasing from itself the ripened ovum, - there is an ovulation. On site the burst follicle temporary education - a yellow body which produces the certain hormones preparing the woman's organism for pregnancy forms. This normal current of an ovarian cycle.

At dystrophic and sclerous changes of tissue of the ovaries which are found at acute and chronic inflammatory processes in uterus appendages at a syndrome of polycystic ovaries and some other diseases, and also at medicamentous stimulation of an ovulation there are certain disturbances in the course of an ovulation and formation of a yellow body. As a result blood vessels in the place of a rupture of an ovary are badly reduced, intra belly bleeding proceeds and amplifies, and in a yellow body because of fragility of vessels hemorrhage - a hematoma forms. All this is followed by a pain syndrome, weakness, dizziness, nausea, vomiting, pallor of integuments, an unconscious state. Without the corresponding treatment internal bleeding can amplify, creating real threat to health and the woman's life. Also carry a stomach injury, excessive physical tension, the rough sexual intercourse, riding etc. to the factors provoking a rupture of an ovary

Symptoms of the Apoplexy of ovaries:

Clinical symptoms of an apoplexy are connected with the main mechanism of development of this pathology:

  1. A pain syndrome which arises first of all in the middle of a cycle or after an insignificant delay of periods (at a rupture of a cyst of a yellow body, for example). Pains are most often localized in lower parts of a stomach. Pains can sometimes irradiate in a rectum, to the lumbar or umbilical area.
  2. Bleeding in an abdominal cavity which can be followed:

    * pressure decrease,
    * increase in pulse,
    * weakness and dizziness,
    * syncopal states,
    * a fever, fervescence to 38 °C,
    * single vomiting,
    * dryness in a mouth.

There can sometimes be intermenstrual blood allocations or blood allocations after a periods delay.

Rather often, the apoplexy of an ovary happens after sexual intercourse or occupation in gym, that is under certain conditions when pressure in an abdominal cavity increases and disturbance of integrity of tissue of ovary is possible. However, the rupture of an ovary can occur also against the background of full health.

Апоплексия правого яичника, внутрибрюшное кровотечение

Apoplexy of the right ovary, intra belly bleeding

Reasons of the Apoplexy of ovaries:

The reasons promoting emergence of an apoplexy of an ovary:

  1. Pathological changes of vessels (varicosity, sclerosis).
  2. The previous inflammatory processes of tissue of ovary.
  3. Ovulation moment.
  4. Stage of vascularization of a yellow body (middle and second phase of a cycle).

Treatment of the Apoplexy of ovaries:

  1.  Conservative treatment is possible only in case of an easy form of an apoplexy of an ovary which is followed by insignificant bleeding in an abdominal cavity.

Patients with an easy form of an apoplexy show complaints first of all to pain in the bottom of a stomach.

However, data of many researchers prove that at conservative maintaining such patients in 85,7% of cases in a small basin commissures are formed, and 42,8% of cases are registered infertility.

Practically at every 2nd woman after conservative maintaining emergence of a recurrence (a repeated apoplexy of an ovary) is possible. It is connected with the fact that blood and clots which collect in an abdominal cavity after a rupture of an ovary (an ovary apoplexy) are not washed away as at a laparoscopy, remain in an abdominal cavity where will be organized and promote formation of commissural process in a small basin.

Conservative treatment can be recommended only to the women who already realized the reproductive function (that is already having children and not planning to have them) in case of identification at them an easy form of an apoplexy of an ovary.

If the woman is in reproductive age and plans pregnancy, then tactics even in case of an easy form of an apoplexy of an ovary has to be reconsidered in favor of a laparoscopy.

Surgical treatment is the basic as not only allows to specify the diagnosis, but also to carry out full correction.

In all cases of an apoplexy carrying out a laparoscopy is possible!!!

The only contraindication to use of this access is hemorrhagic shock (that is very big blood loss with a loss of consciousness).

Operation it is necessary to move in most sparing way with preservation of an ovary.

As a rule, removal of the capsule of a cyst, coagulation or sewing up of an ovary is carried out. In rare instances at massive hemorrhage performance of removal of an ovary is required.

During operation it is necessary to wash out carefully an abdominal cavity, to remove clots and blood, for prevention of formation of commissures and infertility.

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