[A clinical case of unrecognized hemoperitoneum: importance of correct preoperative diagnosis].

A young caucasian man (16 years old) underwent laparatomy after a diagnosis of acute appendicitis. After anesthetic induction, the patient experienced hypotension and tachycardia. The surgical approach discovered a massive haemoperitoneum subsequent to necrosis of the ileum due to internal herniation. The haemoperitoneum was probable responsible for hypovolemia which justified hypotension and tachycardia, which were reversed by aggressive intraoperative volume infusion. The importance of adequate preoperative diagnosis, in order to treat hypovolemia associated with a massive haemoperitoneum, is stressed.