I am sure that many who read the title of the article, will climb in Google, for the definition of “apoplexy of the ovary” — not one of those that is used in the daily life. Felt something wrong, but what lies behind this mysterious and ominous phrase a normal average person in most cases unknown.
Well, I will not weary the waiting, the more that anxiety in this case is justified: the apoplexy is a sudden rupture. Just imagine — a rupture of an internal organ… the Thing is, without a doubt, nesereznaya requiring immediate treatment. Not to say that it’s a common disease: among all the “female” diseases the apoplexy of the ovary accounts for only 2-3%. How to recognize ovarian apoplexy, how to cure, it always shows operation — all of this you learn from our article.
The content of the article
Apoplexy (rupture) of the ovary: where did that come from
Symptom of ovarian apoplexy — spontaneous sharp pain in lower abdomen. Perhaps, before proceeding to the description of symptoms, it is helpful to understand the nature of this pathology. The fact that the female body differs from the male as “Cayenne” from “the Priory”, is an “open secret”. That is, with the structural and technical point of view, it is a more highly organized biological unit, the operation of which within a certain period of his life — reproductive — strictly cyclic. All this time the female ovaries are suppliers of bubble wrap tissue formations of follicles that serve as the container for ripening of the egg. In the initial phase of each menstrual cycle, in some yet unknown to modern science way only selects the dominant follicle: this time the egg will ripen in it. By the middle of the cycle by this time reached 20 mm follicle ruptures and the egg comes out. This is called ovulation. Place the bursting of the former follicle for a long time is not empty: here is a new tissue structure — yellow body, whose role is secretion of female sex hormone, progesterone, prepares the woman for pregnancy.
It happens ideally, but not always. Sometimes this clockwork system interfering with any adverse factors affecting ovarian tissue undergoes sclerotic and dystrophic degeneration, which negatively affects the formation of the corpus luteum. Because of this, in the area of the ruptured follicle locally disturbed circulation, and the ovary begins to bleed (i.e. it is his perforation) into the abdominal cavity with the formation of a hematoma in the yellow body.
Causes of ovarian apoplexy
Among the causes of apoplexy of the ovary, are the following:
- sclerotic changes of the internal walls of blood vessels of the ovary and forms its tissue due to previous inflammatory diseases;
- long-term use of drugs that prevent blood clotting;
- diseases of the blood;
- external mechanical factors which, in combination with the above-mentioned reasons contribute to the increased risk of ovarian apoplexy (abdominal trauma, rough sex, riding, gynecological manipulations).
Symptoms of ovarian apoplexy
The first thing that suggests ovarian apoplexy — spontaneous sharp pain in lower abdomen, “sweep” in the lumbar region of the navel or in the lower limbs. Pain syndrome is associated with irritation of pain receptors of the ovary and peritoneum opened by bleeding, and spasm of the artery of the ovary. The time of development — after a delay of menstruation, or in the middle of the menstrual cycle.
If we are really to delve into the heart of the issue, we should mention the existence of two forms of ovarian apoplexy: hemorrhagic and painful. In the first case, there is a distinct pain without obvious signs of bleeding in the second — on the contrary. But if you think sensibly, if there is no bleeding, there is no apoplexy, therefore, each of the forms cannot exist in the distilled is the only way. In this regard, it is appropriate to highlight not the form of apoplexy, and varying severity, depending on the magnitude of blood loss. So the beginning of diseases characterized by pain symptoms and increasing blood loss appear hemorrhagic (anemia) symptoms. What are the symptoms inextricably linked to the blood loss? Dizziness, weakness, nausea, vomiting, decreased pressure, tachycardia, dry mouth, possible fainting.
Diagnosis of ovarian apoplexy
Feature of diagnosis of ovarian apoplexy is the required speed of the correct diagnosis, given the severe nature of this disease. Algorithm for the diagnosis of ovarian apoplexy includes a primary inspection, during which the doctor observes the patient has a distinct sensation of pain caused by the rupture of the ovary. In a laboratory study of blood is determined as a result of reduced blood loss hemoglobin. To confirm intraperitoneal bleeding is puncture of the posterior fornix of the vagina. Blood in the abdominal cavity and hematoma of the corpus luteum is visible at ultrasound. Final confirmation of the correctness of the diagnosis gives a laparoscopic study.
Treatment of apoplexy technoconservative
Apoplexy of the right ovary In the early stages with little neoprogressive blood loss is possible to do without surgery. Conservative treatment methods include receiving a styptic (etamzilat, dicynone) and antispasmodic (no-Spa, papaverine), vitamins (B1, B6, B12), physiotherapy (electrophoresis of calcium chloride, microwave therapy). However, as practice shows, conservative treatment is not the best choice because of possible recurrence of the disease due to the formation of adhesions in the pelvis. In 50% of cases after conservative treatment of ovarian apoplexy happens again. The blood anywhere from the abdominal cavity does not disappear, and in the future against this background, starts the adhesion process. And the consequences of recurrent ovarian apoplexy is infertility. Conclusion: conservative treatment of ovarian apoplexy is indicated only in mild forms of the disease and only those women who are not planning offspring.
In other cases, as well as direct indications for surgery (the presence of more than 150 ml of blood in the abdominal cavity, repeated episodes of pain, deterioration of General condition) shown surgical treatment. It must be extremely accurate in order to preserve the ovary (except in cases where this is not possible — in cases of heavy bleeding). Coagulation is carried out open or suturing of the ovary, removal of the capsule after puncture of ovarian cyst by suction. The abdominal cavity is rinsed from blood clots to prevent adhesions.
Patients whose treatment apoplexy was started in the early, painful phase, before the massive blood loss, usually carry the disease without serious consequences. If treatment is started too late, when blood loss has reached 50% of the total volume of circulating blood, and possible death.