APPOSSIBLE OF OVAR

Apiaxia of the ovary (syn: rupture of the ovary) - a sudden onset of hemorrhage in the ovary, accompanied by a violation of its integrity and bleeding into the abdominal cavity.

It is most often observed with a rupture of the yellow body, which is formed in the ovary after ovulation. Possible rupture of the yellow body during pregnancy. Often apoplexy occurs against the background of pathological changes in the vessels and ovary tissue due to inflammation of the appendages of the uterus (see Adnexitis), chronic appendicitis, etc. Provocative moments may be trauma, physical overexertion, sexual intercourse (especially interrupted). However, apoplexy of the ovary can also vary in a state of complete rest (even in sleep).

There is apoplexy of the ovary mainly in women 20 - 36 years, usually in the middle or the second half of the menstrual cycle. Suddenly, there is a sharp pain in the lower abdomen on the side of the lesion, which radiates into the anus. With significant bleeding, there is dizziness , weakness, cold sweat, nausea , vomiting , pale skin and visible mucous membranes, increased heart rate, decreased blood pressure, sometimes fainting. In some cases, scarce bloody discharge appears from the genital tract.

With palpation, the muscle tension of the anterior abdominal wall is determined, and often the symptoms of irritation of the peritoneum. With a vaginal examination, the smoothness and pastosity of the posterior vaginal fornix are revealed, sometimes an enlarged sharply painful ovary of a soft consistency can be palpated. In the case of a significant hemorrhage into the abdominal cavity and with pronounced symptoms of irritation of the peritoneum, palpation of the uterus and its appendages is difficult.

When these symptoms appear, the paramedic should urgently take the woman to the nearest hospital. The patient is transported on stretchers in the supine position on the back (the leg end of the stretcher is slightly raised).

Treatment for massive intra-abdominal bleeding operative - suturing the rupture or resection of the ovary. With ovarian apoplexy in a pregnant woman, the ovarian rupture is sutured, while pregnancy is preserved. These interventions in large hospitals are performed laparoscopically. Laparoscopy in such cases allows a differential diagnosis between ectopic pregnancy and appendicitis. In some cases, with minor internal bleeding, a patient's satisfactory condition and complete confidence in the diagnosis, conservative therapy (rest, abdominal cold, anti-inflammatory drugs) is performed. The prognosis for timely treatment is favorable.