International journal of surgery case reports · 2022
A Rare Cause Of Acute Abdomen In Middle-Aged Man: Idiopathic Spontaneous Hemoperitoneum.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Aldhafeeri Sahar, Aljoaib Abdulsalam, Alghumlas Sharifa, Alotaibi Falah, Alghamdi Radhwan, Alghazwi Abdulaziz
Аннотация
INTRODUCTION AND IMPORTANCE: Idiopathic spontaneous hemoperitoneum is a rare and often life-threatening condition. It is an uncommon cause of acute abdomen; it represents a real emergency condition and must be considered in any patient with atypical abdominal pain and hemodynamic instability.
CASE PRESENTATION: This is a detailed case presentation and non-operative management of idiopathic spontaneous hemoperitoneum with atypical abdominal pain. This is 45-year-old male was admitted with a history of progressive abdominal pain for one year. He denied any history of recent trauma, physical assault, bleeding disorder, or drug abuse. The plain abdominal film was unremarkable, and a computed tomographic scan with intravenous contrast (CT) revealed an intra-peritoneal hemorrhage, while esophagogastroduodenoscopy (EGD) and CT angiography (CTA) revealed no abnormality. The patient was managed non-operatively with a good outcome. Six days later, the patient was discharged with further follow-up in outpatient. The follow-up computed tomographic scan with intravenous contrast revealed complete resolution of the hemoperitoneum, and the patient remained asymptomatic.
CLINICAL DISCUSSION: Spontaneous hemoperitoneum is usually the result of an unknown cause in the non-traumatic abdomen. Also, in between 30 and 38 % of documented cases, the source of bleeding could not be determined. The pathogenesis remains unclear. The "double-rupture" phenomenon can explain the clinical deterioration after the initial presentation of the hemodynamically stable.
PATIENT: Prognosis is dependent on early diagnosis and intervention.
CONCLUSION: Success with non-surgical management of idiopathic spontaneous hemoperitoneum has been reported in limited cases, including the present one.
CASE PRESENTATION: This is a detailed case presentation and non-operative management of idiopathic spontaneous hemoperitoneum with atypical abdominal pain. This is 45-year-old male was admitted with a history of progressive abdominal pain for one year. He denied any history of recent trauma, physical assault, bleeding disorder, or drug abuse. The plain abdominal film was unremarkable, and a computed tomographic scan with intravenous contrast (CT) revealed an intra-peritoneal hemorrhage, while esophagogastroduodenoscopy (EGD) and CT angiography (CTA) revealed no abnormality. The patient was managed non-operatively with a good outcome. Six days later, the patient was discharged with further follow-up in outpatient. The follow-up computed tomographic scan with intravenous contrast revealed complete resolution of the hemoperitoneum, and the patient remained asymptomatic.
CLINICAL DISCUSSION: Spontaneous hemoperitoneum is usually the result of an unknown cause in the non-traumatic abdomen. Also, in between 30 and 38 % of documented cases, the source of bleeding could not be determined. The pathogenesis remains unclear. The "double-rupture" phenomenon can explain the clinical deterioration after the initial presentation of the hemodynamically stable.
PATIENT: Prognosis is dependent on early diagnosis and intervention.
CONCLUSION: Success with non-surgical management of idiopathic spontaneous hemoperitoneum has been reported in limited cases, including the present one.