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Vaginal bleeding from massive hemoperitoneum. A case report
P Marcus1, G Raff, J Rothenberg
1Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, USA.
Background:
A gynecology service is often asked to consult and evaluate in-house patients with vaginal bleeding.
Case:
A 31-year-old, Asian woman with a history of end-stage renal disease and hemodialysis was admitted to the hospital with a falling hematocrit. She subsequently began to have heavy vaginal bleeding. Computed tomography suggested a peritoneal-cervical fistula. Subsequent exploratory laparotomy documented that the bleeding was caused by retrograde flow of a hemoperitoneum.
Conclusion:
This appears to be the first reported case of retrograde flow from a hemoperitoneum causing vaginal bleeding. Although unusual, this case expands the differential diagnosis when evaluating vaginal bleeding.