OVARIAN-CARCINOMA PRESENTING AS INTRAABDOMINAL HEMORRHAGE

Ovarian carcinoma commonly has an insidious onset. By the time the dia gnosis is made, advanced disease is usually present. Rarely does a pat ient have acute symptoms which require immediate medical attention and lead to the correct diagnosis. A 40-year-old white female presented w ith lower abdominal pain, nausea, and light-headedness. Physical exami nation revealed a markedly tender lower abdomen with the right lower q uadrant slightly more tender than the left. Hemoglobin level was noted to have decreased 2.6 g/dl over 16 hr. At exploratory laparotomy, 150 0 cc of blood and a ruptured right ovarian mass were found. Pathologic analysis revealed a malignant mixed mesodermal tumor of the right ova ry and an endometrioma of the left ovary. In conclusion, ovarian carci noma may present as an acute abdomen because of intra-abdominal hemorr hage. It should be part of the differential diagnosis in a woman with an acute surgical abdomen and a hemoperitoneum. (C) 1994 Academic Pres s, Inc.