title: Ovarian carcinoma presenting as intra-abdominal hemorrhage.
abstract: Ovarian carcinoma commonly has an insidious onset. By the time the diagnosis is made, advanced disease is usually present. Rarely does a patient have acute symptoms which require immediate medical attention and lead to the correct diagnosis. A 40-year-old white female presented with lower abdominal pain, nausea, and light-headedness. Physical examination revealed a markedly tender lower abdomen with the right lower quadrant slightly more tender than the left. Hemoglobin level was noted to have decreased 2.6 g/dl over 16 hr. At exploratory laparotomy, 1500 cc of blood and a ruptured right ovarian mass were found. Pathologic analysis revealed a malignant mixed mesodermal tumor of the right ovary and an endometrioma of the left ovary. In conclusion, ovarian carcinoma may present as an acute abdomen because of intra-abdominal hemorrhage. It should be part of the differential diagnosis in a woman with an acute surgical abdomen and a hemoperitoneum.
authors.affiliation: Department of Obstetrics and Gynecology, St. Vincent Hospital and Health Care Center, Indianapolis, Indiana 46260.
authors.forename: J P
authors.initials: JP
authors.lastname: Geisler
authors.forename: B J
authors.initials: BJ
authors.lastname: Denman
authors.forename: T J
authors.initials: TJ
authors.lastname: Cudahy
authors.forename: T H
authors.initials: TH
authors.lastname: Lee
authors.forename: H E
authors.initials: HE
authors.lastname: Geisler
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology*; D000328:Adult; D005260:Female; D006465:Hemoperitoneum / Q000175:diagnosis; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D018199:Mixed Tumor, Mesodermal / Q000150:complications*; D010051:Ovarian Neoplasms / Q000150:complications*