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Abdominal apoplexy: a case report and review
1Department of Emergency Medicine, Texas A&M University Health Science Center, College of Medicine, Scott & White Clinic, Temple, Texas 76508, USA.
The Journal of Emergency Medicine
|August 9, 2008
Summary
Idiopathic spontaneous intraperitoneal hemorrhage (ISIH) is a rare cause of non-traumatic bleeding. Prompt diagnosis and surgical intervention, like ligation of the bleeding artery, are crucial for patient recovery.
Area of Science:
- Gastroenterology
- Emergency Medicine
- Surgical Pathology
Background:
- Idiopathic spontaneous intraperitoneal hemorrhage (ISIH), also known as abdominal apoplexy, is a rare condition characterized by non-traumatic intra-abdominal bleeding.
- Patients often present to the Emergency Department (ED) with symptoms of acute blood loss, necessitating rapid evaluation and resuscitation.
Observation:
- A case report details a 52-year-old male experiencing abdominal pain and distention due to ISIH.
- The patient exhibited signs of impending cardiovascular compromise in the ED.
- Computed tomography (CT) scan confirmed an intra-abdominal hematoma.
Findings:
- Emergent exploratory laparotomy revealed spontaneous bleeding from a branch of the middle colic artery.
- The bleeding vessel was successfully ligated without complications.
- The patient experienced a full recovery with no recurrence of bleeding.
Implications:
- This case highlights the importance of considering ISIH in the differential diagnosis of non-traumatic abdominal bleeding.
- Early diagnosis via imaging and prompt surgical management are critical for favorable outcomes.
- Reviewing the pathophysiology, diagnostics, and treatment of ISIH is essential for clinicians managing such rare emergencies.
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