Twelve Years of Unexpected Bleeds: Hemoperitoneum as a Rare Twist in Rare Bleeding Disorders

Massive hemoperitoneum is rare and associated with underlying systemic or local pathology. We report 8 episodes of hemoperitoneum in 7 children with rare bleeding disorders who presented with acute abdominal pain. The diagnosis was by imaging, and all responded with conservative treatment. Hemorrhagic corpus luteal cyst was the most common etiology in adolescent girls. Oral contraceptive pill (OCP) prophylaxis was used to prevent recurrence. Optimal management can be attained by a high index of suspicion, careful clinical assessment, multidisciplinary treatment, close follow-up, and prophylaxis when feasible, to prevent recurrences.