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A Rare Cause Of Acute Abdomen In Middle-Aged Man: Idiopathic Spontaneous Hemoperitoneum

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 P...

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Detalles Bibliográficos
Autores principales: Aldhafeeri, Sahar, Aljoaib, Abdulsalam, Alghumlas, Sharifa, Alotaibi, Falah, Alghamdi, Radhwan, Alghazwi, Abdulaziz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9568867/
https://www.ncbi.nlm.nih.gov/pubmed/36152370
http://dx.doi.org/10.1016/j.ijscr.2022.107691
Descripción
Sumario: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.