Clinical and laboratory presentation of hemorrhagic corpus luteum

Objective: The differential diagnosis of symptomatic hemorrhagic corpus luteum includes various causes of acute abdomen that are usually associated with either leukocytosis and/or fever. The aim of this study was to evaluate whether hemorrhagic corpus luteum could also be associated with the clinical and/or laboratory presentation of acute abdomen. Methods: This work was a retrospective case series study, including 84 hospitalizations (81 women) owing to symptomatic hemorrhagic corpus luteum from January 2005 to February 2006. Results: The most prevalent complaint, common to all women, was abdominal pain. Other symptoms and signs included fever (10.7%), nausea or vomiting (13%), urinary complaints (9%), and shoulder pain (1.1%). The mean hemoglobin concentration was 12.8 g/L on admission and 11.9 g/L on discharge. White blood cell (WBC) counts exceeding 11,000 cells/mL were present on admission in 33% of patients. The WBC count repeated before discharge decreased significantly (from 14,051 cells/mL to 8131 cells/mL; p < 0.01). Further, the presence of leukocytosis on admission was correlated with other clinical, laboratory, and ultrasonographic findings. We found a significant correlation between leukocytosis, a marked decrease in hemoglobin concentration, and a longer hospital stay. Conclusion: Leukocytosis may be a feature of hemorrhagic corpus luteum. The presence of fever, nausea, vomiting, and, particularly, leukocytosis should not rule out the diagnosis of hemorrhagic corpus luteum when evaluating women with acute abdominal pain.