Ovarian hyperstimulation syndrome complicated by peritonitis due to perforated appendicitis

We describe a case of ovarian hyperstimulation syndrome (OHSS) complicated by peritonitis due to perforated appendicitis. A 29-year-old woman presented with abdominal distension after ovarian stimulation with HMG followed by ovulation induction with HCG. Massive ascites with swollen ovaries was obse...

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Bibliographic Details
Published in:Human reproduction (Oxford) 2002-04, Vol.17 (4), p.966-967
Main Authors: FUJIMOTO, Akihisa, OSUGA, Yutaka, YANO, Tetsu, KUSUMI, Maki, KUROSAWA, Takako, FUJII, Tomoyuki, TAKETANI, Yuji
Format: Article
Language:English
Subjects:
Adult
Appendectomy
Appendicitis - complications
Appendicitis - surgery
Bacterial Infections
Biological and medical sciences
Drainage
Fallopian Tubes - surgery
Female
Female genital diseases
Gynecology. Andrology. Obstetrics
Humans
Intestinal Perforation - complications
Intestinal Perforation - surgery
Medical sciences
Non tumoral diseases
Ovarian Hyperstimulation Syndrome - complications
Peritoneal Lavage
Peritonitis - etiology
Peritonitis - microbiology
Peritonitis - surgery
Pregnancy
Pregnancy, Ectopic - complications
Pregnancy, Ectopic - surgery
Rupture, Spontaneous
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Summary:We describe a case of ovarian hyperstimulation syndrome (OHSS) complicated by peritonitis due to perforated appendicitis. A 29-year-old woman presented with abdominal distension after ovarian stimulation with HMG followed by ovulation induction with HCG. Massive ascites with swollen ovaries was observed on ultrasound, and she was admitted on the diagnosis of OHSS. Daily infusion of serum albumin and low dose dopamine failed to increase her urine output and her abdominal symptoms became increasingly deteriorated after her urine pregnancy test turned out to be positive. Paracentesis performed for alleviation of her abdominal distension revealed infected, foul-smelling fluid. An emergency laparotomy was performed, and the definite diagnosis was made as panperitonitis due to perforated appendicitis with right tubal pregnancy. Appendectomy, right tubectomy and vigorous irrigation with drainage were performed. The case implies that OHSS might not only mask typical manifestations of appendicitis, but could also compromise concurrent intraperitoneal infection.
ISSN:0268-1161
1460-2350
DOI:10.1093/humrep/17.4.966