Massive intra-abdominal bleeding caused by nontraumatic rupture of a vein in the colorenal ligament: Report of a case

Abstract

We report a case of acute abdomen caused by nontraumatic intra-abdominal bleeding in a 38-year-old man. Emergency laparotomy revealed the source of bleeding as a vein in the right colorenal ligament. The rupture of this vein may have been attributable to shear stress after severe vomiting on the day before admission. Although the patient had a coagulation disorder secondary to early-stage liver cirrhosis, there were no signs of portal hypertension intraoperatively. This report describes an unusual cause of acute hemoperitoneum, highlighting the importance of including this life-threatening disorder in the differential diagnosis of acute abdomen of unknown origin. Its outcome is dependent on early diagnosis and prompt emergency intervention.

Spontaneous rupture of the umbilical vein associated with liver cirrhosis: A case report

“…Atraumatic hemoperitoneum is mostly caused by bleeding from tumors, gynecological causes, and rupture of an intra-abdominal blood vessel in some vascular pathologies such as aneurysms and arteriovenous malformations. Previous case reports have introduced some rare situations regarding rupture of several blood vessels: inferior pancreaticoduodenal artery aneurysm [5] , pseudoaneurysm from the middle colic artery [6] , rupture of a vein in the colorenal ligament [7] , retroperitoneal varix [8] , rupture of the left gastric vein [9] , and gallbladder hemangioma [10] . To our knowledge, there are only a few reports regarding a hemoperitoneum caused by a spontaneous rupture of the umbilical vein [11] , [12] , [13] , [14] , [15] .…”