Spontaneous hemoperitoneum

Abstract

Massive hemoperitoneum seen without an obvious precipitating event is rare. A 21-year-old man was seen with diffuse abdominal pain of 48 hours' duration. He had no fever, nausea, or vomiting, and most laboratory values were normal. Exploration of the abdomen revealed free intraperitoneal blood with clotting but failed to reveal a source. The patient could recall no trauma or other inciting event. The only abnormalities found during laparotomy were multiple adhesions of the omentum to the lateral abdominal wall and localization of most of the clot within the greater omentum. The author cautions that a high index of suspicion followed by laparotomy are the management tools for controlling spontaneous hemoperitoneum. Conservative management produces a high mortality rate.

Bleeding from ruptured hepatic metastases as a cause of syncope in an octogenarian: a case report

“…The literature reports laparotomy as a management option for metastatic hepatic hemorrhage but this would entail surgical risks for the patient [11,12]. In hemoperitoneum occurring as a result of rupture of hepatocellular carcinoma, transcatheter arterial embolization has been previously described as a potential therapeutic option [1,2].…”