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Intra-abdominal hemorrhage from ruptured varices
Archives of Surgery (Chicago, Ill. : 1960)
|July 1, 1982
Summary
Ruptured intraperitoneal varices in Laënnec's cirrhosis can cause hemoperitoneum. Early diagnosis via paracentesis and surgical intervention, like suture ligation, improve survival rates for this critical condition.
Area of Science:
- Gastroenterology
- Hepatology
- Surgical Oncology
Background:
- Laënnec's cirrhosis, a severe liver condition, can lead to serious complications.
- Intraperitoneal varices are fragile blood vessels that can rupture, causing internal bleeding.
Observation:
- Three patients with Laënnec's cirrhosis presented with anemia, abdominal pain, and abdominal distension.
- Hemoperitoneum was diagnosed through paracentesis, with laparotomy revealing ruptured intraperitoneal varices.
Findings:
- Two patients with severe depletion died, while one patient with initial orthostatic changes survived.
- A review of 11 prior cases indicated abdominal pain, hypotension, and distension as common initial symptoms.
Implications:
- Early abdominal paracentesis is crucial for diagnosing hemoperitoneum in cirrhosis patients.
- Suture ligation of bleeding varices offers the best chance of survival for patients with ruptured intraperitoneal varices.