Idiopathic Spontaneous Intraperitoneal Haemorrhage

Area of Science:

• Medicine
• Surgery
• Gastroenterology

Background:

• Idiopathic spontaneous intraperitoneal hemorrhage (ISIH) is a rare, life-threatening condition.
• Pre-operative diagnosis of ISIH is challenging, often necessitating urgent surgical exploration.
• The condition presents with sudden abdominal pain and signs of shock.

Observation:

• A patient in a hospital ward developed severe abdominal pain and weakness, progressing to shock.
• Resuscitation and urgent abdominal ultrasound revealed free fluid, indicative of bleeding.
• Laparotomy confirmed spontaneous intraperitoneal bleeding with a minor peritoneal breach.

Findings:

• No significant bleeding source was identified beyond a small breach in the peritoneum.
• Hemostasis was achieved with simple surgical stitches.
• Postoperative imaging and a 6-month follow-up showed no recurrence or complications.

Implications:

• This case highlights the importance of prompt surgical exploration in suspected ISIH, even with diagnostic uncertainty.
• It suggests that minor peritoneal defects can occasionally lead to significant spontaneous hemorrhage.
• Successful management underscores the efficacy of surgical intervention for ISIH.