Cases reported "Hemoperitoneum"

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1/34. hemoperitoneum following rupture of ectopic varix along splenorenal ligament in extrahepatic portal vein obstruction.

    A 29-year-old man with extrahepatic portal vein obstruction who underwent variceal eradication by sclerotherapy six years ago, was admitted with hypotension and abdominal pain. Abdominal paracentesis yielded frank blood. laparotomy showed bleeding from a large ectopic vessel along the splenorenal ligament. The vessel was ligated and the patient recovered.
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2/34. ehlers-danlos syndrome type IV and a novel mutation of the type III procollagen gene as a cause of abdominal apoplexy.

    Abdominal apoplexy is a clinical entity characterized by spontaneous intraperitoneal hemorrhage from rupture of a visceral vessel. We describe a 34-year-old man who presented with abdominal apoplexy due to rupture of an ileocolic aneurysm. Subsequent biochemical and genetic analysis confirmed the diagnosis of ehlers-danlos syndrome type IV based on abnormal production of type III procollagen and a novel mutation in the COL3A1 gene. patients presenting with abdominal apoplexy should undergo a thorough examination so that the underlying vascular pathology can be identified.
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3/34. Internal hemorrhage caused by a twisted malignant ovarian dysgerminoma: ultrasonographic findings of a rare case and review of the literature.

    PURPOSE: Ovarian cancer presents as an acute abdomen very rarely. The purpose of the study is the description of a right ovarian malignant dysgerminoma presenting as an abdominal emergency. CASE: A 16-year-old white female presented with acute abdominal pain in the right iliac fossa. On physical examination the abdomen was acute and a mass in the right lower abdomen was palpated. The patient was sexually active and bimanual gynecological examination revealed the presence of a large lobulated solid tumor in the position of the right adnexa. Ultrasound examination showed the presence of a large, multilobulated, heterogeneous, predominantly solid pelvic mass. color flow imaging showed intratumoral flow signals. The uterus and the left ovary had normal size and echo-texture. Fluid was found in the cul-de-sac and in Morisson's space. An immediate exploratory laparotomy exposed the presence of a twisted right ovarian mass and intraperitoneal hemorrhage. A superficial tumoral vessel actively bleeding was seen. Peritoneal fluid was obtained for cytology. The intra-abdominal hemorrhage ceased when the ovarian pedicle was clamped. The patient underwent right salpingo-oophorectomy and biopsy of the omentum. Pathologic analysis revealed a malignant dysgerminoma of the right ovary, expanding to the mesosalpinx. Cytology was positive for malignancy. Postoperative CT scan of the upper and lower abdomen was negative. The patient was assigned to FIGO Stage IIC and referred for platinum-based chemotherapy. CONCLUSION: Ovarian malignant dysgerminoma may present as an acute abdomen because of torsion, passive blood congestion, rupture of superficial tumoral vessels and subsequent intra-abdominal hemorrhage. Ovarian dysgerminoma should be part of the differential diagnosis in a young woman with acute surgical abdomen and a solid heterogeneous pelvic mass detected by ultrasonographic scan.
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4/34. Spontaneous rupture of the uterine vessels in pregnancy.

    BACKGROUND: hemoperitoneum resulting from spontaneous rupture of the uterine vessels in pregnancy is rare and associated with high maternal and fetal mortality. CASE: A woman presented with acute abdominal pain and hypovolemic shock at 20 weeks of gestation. Immediate laparotomy revealed massive hemoperitoneum resulting from spontaneous rupture of the left uterine vessels associated with a left adnexal mass consisting of decidualized endometriosis. The fetus was delivered by hysterotomy, hemostasis was achieved, and the woman made a good recovery. CONCLUSION: We report a case of hemoperitoneum in pregnancy that resulted from spontaneous rupture of the uterine vessels associated with decidualized endometriosis.
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5/34. Postcoital haemoperitoneum: a cause for shock.

    Postcoital haemoperitoneum rarely occurs without evident vaginal injury. A 21-year-old second gravida woman presented to the ED in shock with a history of 8 weeks amenorrhoea and abdominal pain of 20 h duration. The ultrasound examination revealed a live intrauterine pregnancy and fluid in peritoneal cavity. There was a history of coitus 2 hours prior to the onset of pain. At laparotomy, more than 2 L of free blood was found in the peritoneal cavity. A small bleeding peritoneal vessel in pouch of Douglas was identified and ligated.
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6/34. Abdominal apoplexy: a case study of the spontaneous rupture of the gastroepiploic artery.

    This is a case report of abdominal apoplexy (AA) or spontaneous rupture of a visceral vessel, without associated aneurysmal dilation of the vessel. Spontaneous rupture of the left gastroepiploic artery (LGEA) resulting in a hemoperitoneum is discussed. The clinical presentation of left lower quadrant abdominal pain, along with the histologic findings of medial degeneration of the LGEA, makes this case an unusual one. The incidence, origin, associated predisposing medical conditions, clinical presentation, and treatment of abdominal apoplexy are discussed.
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7/34. Acute abdomen as first symptom of acute leukemia.

    CASE REPORT: The authors presented a rare case of acute abdomen syndrome caused by the rupture of the corpus rubrum as the first symptom in a 35-years-old woman with the acute lymphatic leukemia. During the laparotomy is notice diffuse bleeding from under skin blood vessels and muscles. The blood was electrocoagulated and was sewn with catgut sutures. The right ruptured corpus rubrum was found from which fresh blood was leaking. The right ovary was carefully resected and sutured, and each ligature was bleeding. At the beginning of the surgery laboratory analysis results arrived which showed a high leukocytosis (28.0 x 10(9)/l) with sever thrombocytopenia (10 x 10(9)/l) and afibrinogenemia (0.1 g/l) with anemia (1.9 x 10(12)/l erythrocyte, haematocrit 0.24), which indicated leukemia with disseminated intravascular coagulopathy (antithrombin iii levels 0.9 g/l, D-dimers 1989 micro g/l). RESULT. A year later she died with the picture of severe disseminated intravascular coagulopathy, agranulocytosis and septic condition with multiorganic failure.
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8/34. hemoperitoneum in a patient with ANCA-associated polyangiitis syndrome.

    Antineutrophil cytoplasmic antibody-associated vasculitides often cause small-vessel vasculitis, usually involving the kidney. Involvement of other organ systems and medium to large arteries is recognized, but free-vessel rupture is rare. A case of a man with classic renal involvement caused by microscopic polyangiitis associated with multiple episodes of hemoperitoneum secondary to splanchnic vasculitis is described. Although his renal vasculitis responded to conventional immunosuppressive treatment, relentless progression of splanchnic vasculitis ultimately proved fatal.
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9/34. Spontaneous haemoperitoneum secondary to a Meckel's diverticulum.

    Meckel's diverticulum is a relatively common gastrointestinal entity which occasionally causes complications. Meckel's diverticulum is classically described to mimic acute appendicitis when inflamed as well as being a cause of unexplained luminal gastrointestinal bleeding. An unusual cause of spontaneous non traumatic haemoperitoneum found during surgery performed for a suspected acute appendicitis in a 22-year old female is described. The patient was found to have a significant haemoperitoneum due to a bleeding serosal vessel of a Meckel's diverticulum. The diverticulum was routinely excised. It was macroscopically and histologically devoid of inflammation. The bleeding vessel was not found to be abnormal or part of an arteriovenous malformation.
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10/34. Fatal hemoperitoneum from traumatic gallbladder avulsion: an autopsy case report.

    This report describes a rare autopsy case of death due to gallbladder injury. The victim was a 63-year-old man, with a clinical history of liver cirrhosis and alcohol abuse. The postmortem examination revealed fatal hemoperitoneum from traumatic gallbladder avulsion. Related injuries were observed in the right hypochondriac region. Normal distended gallbladder, liver cirrhosis and alcohol abuse were considered to be the predisposing factors. The gradual development of bleeding from the small vessels of the gallbladder and the liver bed may have caused extensive hemoperitoneum.
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