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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.

The Journal of Reproductive Medicine
|September 8, 2001
PubMed
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This case report details a rare instance of vaginal bleeding caused by retrograde hemoperitoneum flow in a hemodialysis patient. This unusual presentation expands the differential diagnosis for gynecologic bleeding.

Area of Science:

  • Gynecology
  • Nephrology
  • Radiology

Background:

  • Vaginal bleeding is a common gynecologic complaint requiring evaluation.
  • Patients with end-stage renal disease (ESRD) on hemodialysis present unique management challenges.

Observation:

  • A 31-year-old woman with ESRD on hemodialysis experienced heavy vaginal bleeding.
  • Imaging suggested a peritoneal-cervical fistula, later confirmed during surgery.

Findings:

  • Exploratory laparotomy revealed bleeding due to retrograde flow from a hemoperitoneum.
  • This is the first reported case of hemoperitoneum causing vaginal bleeding via retrograde flow.

Implications:

  • This case highlights the importance of considering unusual etiologies for vaginal bleeding, even in patients with significant comorbidities.

Related Experiment Videos

  • The findings expand the differential diagnosis for gynecologic bleeding, particularly in patients with renal disease.