Postcoital haemperitoneum without vaginal injury, a clinical challenge

Post coital hemoperitoneum: The pain of love

Acute abdominal pain in women of reproductive age is common and frequent cause for visit to emergency department which warrants emergent evaluation. We present the case of a 23-year-old nulliparous women presenting with post-coital haemoperitoneum secondary to a ruptured corpus luteum cyst. This is a rare case demonstrating the need to elicit sexual history in patients presenting with an acute abdomen in emergency department.

Postcoital hemoperitoneum caused by ruptured corpus luteal cyst: a hidden etiology

Corpus luteal rupture is a common gynecologic cause for hemoperitoneum. Recent sexual intercourse is usually a preceding factor. However, postcoital hemoperitoneum without evident vaginal injury or trauma is rarely reported. We present a 34-year-old female who presented to the emergency department with severe bilateral lower quadrant abdominal pain after sexual intercourse. CT of the abdomen and pelvis revealed an intra-abdominal hematoma with extravasation of contrast questionable to be from one of the branches of the left internal iliac artery, and no adnexal abnormalities. Left internal iliac artery angiogram was performed and revealed no active extravasation. Exploratory laparotomy was performed and revealed an actively bleeding left ovarian ruptured area that was repaired and biopsied. No evidence of cysts was observed. Histopathological examination revealed a hemorrhagic corpus luteal cyst. Suspicion for corpus luteal rupture as a cause of postcoital hemoperitoneum should be maintained despite nonevidence of cysts on CT or intraoperatively.

Post-coital genital injury in healthy women: A review

Female genital injury following penile sexual intercourse in healthy women is a matter of importance and debate in many parts of society. However, the literature on the subject is sparse. There are a few studies regarding minor injury that does not require treatment in adult, pre-menopausal women, a single study of adolescent women, and none regarding post-menopausal women. Larger lesions requiring treatment are described casuistically. The purpose of this article is to provide a short, easy-to-read review of the literature regarding the prevalence and nature of female genital injury following consensual sexual intercourse in otherwise healthy women.