[outline]
??The ovary soaks or Huang Ti maturely, because some kind of reason causes the package of wall breakage, the hemorrhage, serious may create the massive abdominal cavity internal hemorrhage, is the ovarian rupture, therefore has the graafian follicle breakage and Huang Tihuo the yellow body cyst bursts two kinds. , The unmarried woman has been possible to occur, as most sees take the period of duration age.
[etiology]
??(one) spontaneous breakage: Namely the graafian follicle haematoma or the yellow body haematoma continue to expand, the intrinsic pressure increases to the certain extent namely has the breakage. It occurs also has several kind of causes:?Has the close relation with the ovary hyperemia, like the ovary because of the oppression reverse either the metroptosis, long-term vagina syringe and so on mechanicalness factors or the pelvic cavity inflammation, the ovary hyperemia which anxious, the chronic appendicitis causes;?Ovarian function change, like excessive cold, hot bath, for a long time can cause ovary’s function change using the estrogen or the progestogen, because either the nervus autonomici system’s influence causes the ovary enzyme system’s function to be excessively active, creates the hemorrhage tendency or the hemoglutination barrier;?The blood change, the menstruation reason infectious disease, anemia and the malnutrition or other situations cause the blood platelet part harm and the blood ingredient change, causes the hemorrhage.
??(two) the ovary direct or is had indirectly the external force influence the breakage, like the sexual intercourse, the intra-abdominal pressure increase (bowel movement effort, disgusting, vomit, to lift heavy item and so on).
[clinical manifestation]
??Generally does not have the menstruation anomalous medical history or the menopause history, most probably is taken bad before the menstruation intermediate stage or the menstruation, gets up gets sick rapidly, gets down the abdomen sudden severe pain, after short time, becomes the endurance to fall the pain, later will reduce gradually or becomes critical. Occasionally may have, the vomit not to be but remarkable disgusting. Generally bleeds without the vagina, internal hemorrhage serious may have the shock symptom.
??Physical examination: The light underbelly only has touches a sore spot mildly, occurs in the right flank tender area, in Ma selects in underneath, the position is low, the critically ill underbelly touches a sore spot obviously, has the bounce pain, but the musculi abdominis strong straight phenomenon was inferior that pan-sends the peritonitis.
??The doublet examines: The cervix of the uterus lifts the pain, two side domes department have touch a sore spot. Womb normal big, motion palace body ache. The internal hemorrhage are many when may feel after appendix area or, the dome swollens fully. Sometimes may touch the ovary which increases.
[diagnosis]
??Because the ovarian rupture lacks the typical symptom diagnosis to be difficult, and often occurs in right flank, is really easy and the acute appendicitis confuses, also mixes easily with the extra-uterine pregnancy harms. Correct diagnosis, what is most main is the inquire closely menstruation history union clinical manifestation and the inspection, overall analysis.
??The ovarian rupture time and the menstrual cycle has certain relations, may take the diagnosis the main basis. Ovarian rupture 80% about Huang Tihuo the yellow body cyst bursts, thus generally after the ovulation period, mostly 1st the week in menstrual cycle end, occasionally may in the monthly period 12th day of morbidity. The minority case bursts for the graafian follicle, often occurs in the mature follicle, thus is taken bad generally in the menstrual cycle from tenth day to 18 days. The ovarian rupture patient common non-ovarian function barrier medical history, has the ovulatory cycle most. The abdomen touches a sore spot not obviously, but the doublet examines the pelvic cavity to touch a sore spot extremely obviously, the union menstruation medical history, many may make the diagnosis. If has the sexual intercourse sequela history, then the possibility is bigger.
[differential diagnosis]
??(one) acute appendicitis: The ovarian rupture occurs in right flank are many, the extremely easy error diagnostic is the acute appendicitis. The acute appendicitis gets up gets sick often for the epigastrium painful or the full abdominal pain, gradually limits to Ma the spot, disgusting, the vomit is prominent, the tenderness, the bounce pain and the musculi abdominis strong straight are obvious. The doublet examines: The cervix of the uterus lifts the pain and the womb mobilized pain is slight, but the ovarian rupture completely is opposite with it. The light ovarian rupture symptom alleviates gradually, but the acute appendicitis has the internal hemorrhage symptom and the symptom, but does not have at the appendicitis.
??(two) the tubal pregnancy bursts or the miscarriage: The ovarian rupture easy to misdiagnose for the tubal pregnancy bursts or the miscarriage, but if can the inquire closely menstruation history, the attention pathological change occur in the menstrual cycle time, generally still could distinguish. The tubal pregnancy common short-term menopause history, the vagina bleeds few, manifests suddenly repeatedly abdominal pain. The pelvic cavity touches hurts obviously, may hold a package of block. Other like sterile medical history and so on, is different with the ovarian rupture.
[remedial measure]
??Has bedrest, the strict observation, takes the traditional Chinese medicine to invigorate the blood to remove extravasted blood, to attack a fortified position the broken product primarily, suitable Canada clearing heat and detoxication medicine.
??The internal hemorrhage has the shock symptom excessively much, the condition emergence, should immediately the surgery, in order to avoid delay treatment.
??The surgery principle must try to preserve the ovarian function. Generally can see that ovary’s broken opening or the blood from Huang Tizhong who recently formed flow out. The available thin catgut chain-like sutures the broken opening or the gouging after the yellow body cyst chain-like sutures the edge then.
