Corpus luteum rupture was the surprise cause of an acute abdomen for this woman in her 20s, who presented to hospital after missionary sex triggered severe abdominal pain.

She told doctors the pain had begun in the right iliac fossa and spread to the whole abdomen during what she described as “ordinary missionary intercourse”.

She had hypotension (90/60mmHg), tachycardia (120bpm) and a respiratory rate of 18 breaths per minute on presentation, her clinicians from Northern Ireland said.

There was no associated nausea, vomiting, fever, vaginal bleeding or trauma.