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Spontaneous hemoperitoneum

¹US Naval Hospital, Yokosuka, Japan.

The Journal of the American Osteopathic Association

|June 1, 1996

Summary

Spontaneous hemoperitoneum without a clear cause is rare. Prompt surgical exploration (laparotomy) is crucial for diagnosis and managing this condition, as conservative approaches carry high mortality risks.

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Area of Science:

Abdominal Surgery
Gastroenterology
Emergency Medicine

Background:

Massive hemoperitoneum, or bleeding into the abdominal cavity, typically has an identifiable cause.
Spontaneous hemoperitoneum without a precipitating event is an uncommon clinical presentation.

Observation:

A 21-year-old male presented with diffuse abdominal pain and significant intraperitoneal bleeding.
No trauma or other inciting event was reported by the patient.
Laparotomy revealed free blood and clots, primarily localized within the omentum, with adhesions to the abdominal wall.

Findings:

The source of the massive hemoperitoneum was not immediately apparent during surgical exploration.
Omental adhesions were the only significant intra-abdominal abnormality noted.

Implications:

A high index of suspicion is necessary for diagnosing spontaneous hemoperitoneum.
Laparotomy is the recommended management strategy to control bleeding and reduce mortality.
Conservative management of spontaneous hemoperitoneum is associated with a high mortality rate.

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