Ovary apoplexy is a sudden rupture of the ovary, which is accompanied by a strong pain syndrome and bleeding into the abdominal cavity. The clinic of the acute abdomen is developing. Apoplexy of the ovary requires differential diagnosis with surgical diseases, such as appendicitis, peritonitis and others.
- 1 Causes of ovarian apoplexy
- 2 Symptoms of ovarian apoplexy
- 3 Treatment of ovarian apoplexy
- 4 Consequences of ovarian apoplexy
Causes of ovarian apoplexy
In the normal menstrual cycle in the ovaries maturation and growth of the follicles occurs, which makes it possible to become pregnant. After the termination of the last menstruation, a new cycle of follicle development starts in the ovary: one dominant is formed, which suppresses the growth of all the others. Then the follicle bursts and releases an egg, ready for fertilization. And on the place where the follicle burst, a yellow body forms, which becomes, when pregnancy comes, the first source of nutrition for the future baby.
If this process is broken, a pathological condition arises.
So, among the reasons that can cause ovarian apoplexy, we can distinguish the following:
Among the internal isolates:
- inflammatory changes in the small pelvis that cause changes in the ovaries;
- blood diseases, which are manifested by a decrease in blood clotting;
- varicose enlargement of ovarian veins;
- hormonal diseases of the female body.
External factors contributing to the development of pathology:
- administration of anticoagulant medications that cause a decrease in blood clotting;
- stressful situations;
- neuropsychic factors.
As a result of all the above factors, dystrophic and sclerotic changes in the ovaries develop. Because of this, after the rupture of the follicle, the vessels are not able to contract sufficiently, which causes the bleeding to continue, and blood is also poured into the yellow body, which causes the formation of a yellow body's hematoma.
Symptoms of ovarian apoplexy
There are three forms of ovarian apoplexy:
- is anemic;
With painful form of ovarian apoplexy, there is a very pronounced pain syndrome, but there are no signs of abdominal bleeding.
With anemic form of ovarian apoplexy, there are signs of internal bleeding, but no pain syndrome.
With a mixed form of ovarian apoplexy, there are signs of internal bleeding and severe pain syndrome.
However, this classification is rather conditional, since with apoplexy as a result of rupture of the ovary in any case, internal bleeding is present.
This is why the classification based on the blood loss value is currently accepted:
- mild degree - the volume of blood loss does not exceed 150 ml;
- medium degree - from 150 to 500 ml;
- severe blood loss - more than 500 ml.
Clinic of ovarian apoplexy depends on its shape. If a woman has a painful form of rupture of the ovary, the clinic will begin with an acute sudden pain in the lower abdomen. In this case, it will hurt from the rupture of the ovary. In addition, pain occurs in the middle of the menstrual cycle, which is an important differential sign of pathology from other diseases. The painful form is very often confused by doctors with acute appendicitis, as a result of which an erroneous operation can be made.
If the first signs of internal bleeding, the woman is characterized by complaints of general weakness, dizziness, possible fainting, the appearance of dyspnea. The woman will be pale, acrocyanosis of the lips, nose, ear shells, fingertips is possible. Skin to the touch will be cold. Soreness may be present, however, not as pronounced as in the painful form.
With a mixed form, it is possible to identify complaints that are characteristic for both painful and mixed forms of ovarian apoplexy.
For internal bleeding, the following symptoms may be characteristic:
- decrease in blood pressure, which causes fainting, dizziness;
- increased heart rate, because blood goes beyond the vessels and the heart has to give more blood to all organs and systems;
- general weakness, dizziness;
- chills or fever above 380C;
- nausea, vomiting;
- dry mouth.
Treatment of ovarian apoplexy
Like many diseases, ovarian apoplexy is treated with two methods: conservatively and operatively.
Conservative treatment is possible only with mild blood loss, without significant clinical manifestations and complaints from the woman, or with contraindications for surgical intervention.
Surgical treatment is the main and radical method of treatment of ovarian rupture.
The most commonly used for surgical intervention is the laparoscopy method. This avoids unnecessary scarring after surgery, which makes this method of treatment very attractive for most women. With this method of treatment, three small incisions are made: two laterally and one in the navel area. After the operation, they remain virtually invisible.
If laparoscopically fails to stop bleeding, then a median incision is made-lapatrotomy.
The operation can be organ-preserving or with removal of the ovary. In all cases, they try to perform an organ-preserving operation, since the ovary is a hormone-producing organ.
Consequences of ovarian apoplexy
If ovarian apoplexy had an unexplained clinical symptomatology or an incorrect diagnosis was made, or the treatment was inadequate, the development of adhesions, that is, attaching the ovary to the intestinal loops or any other organs, is inadequate.
As a rule, in the presence of pain syndrome, the recovery of a woman is complete, as she promptly consults a doctor.
But in the presence of anemic form of ovarian apoplexy, severe consequences may develop due to internal bleeding, which may not be recognized, or recognized late, when the blood loss is significant.
Therefore, in order to keep your life safe, you should not engage in self-medication. At the first signs of the disease, it is necessary to urgently see a doctor.