A case report of idiopathic spontaneous peritoneal and retroperitoneal hematoma of a pregnant woman

CONTEXT: Peritoneal and retroperitoneal hematoma are usually secondary to trauma, an obstetrical pathology, an aneurysmal pathology or a tumorous pathology. A spontaneous idiopathic form remains rare, especially when it occurs to a pregnant woman, which makes the clinical and etiological diagnosis difficult, as well as the therapeutic management both the mother and the fetus. CASE REPORT: We report the case of a spontaneous idiopathic hemoperitoneum and hemoretroperitoneum of a 26-year-old woman, pregnant (30th week of amenorrhea), presenting a hemodynamic instability and a clinical acute surgical abdomen. No secondary cause was identified during exploratory laparotomy, neither through imaging. The therapeutic management relied on hemodynamic stabilization after exploratory laparotomy. CONCLUSION: Idiopathic spontaneous peritoneal and retroperitoneal hematoma -in the presence of several differential diagnoses-remain an extremely rare entity to evoke in front of an acute surgical abdomen in a pregnant woman.