Hemoperitoneum

Hemoperitoneum refers to the presence of blood within the peritoneal cavity, the area that contains the abdominal organs. This condition can result from various causes, including trauma, ruptured ectopic pregnancy, splenic rupture, and complications from medical procedures. Hemoperitoneum is a potentially life-threatening condition that requires prompt medical attention to identify and treat the underlying cause.

Causes[edit | edit source]

Hemoperitoneum can be caused by several factors, which can be broadly classified into traumatic and non-traumatic origins.

Traumatic[edit | edit source]

Trauma is a common cause of hemoperitoneum, often resulting from:

Blunt abdominal trauma, such as from a car accident or fall
Penetrating trauma, such as stab or gunshot wounds

Non-Traumatic[edit | edit source]

Non-traumatic causes of hemoperitoneum include:

Ruptured ectopic pregnancy, where a fertilized egg implants outside the uterus
Splenic rupture, which can occur spontaneously or due to underlying conditions like mononucleosis or malaria
Liver diseases, including hepatocellular carcinoma or liver metastasis
Gynecological disorders, such as ovarian cyst rupture or endometriosis
Complications from medical or surgical procedures

Symptoms[edit | edit source]

Symptoms of hemoperitoneum can vary depending on the amount of blood loss and the rate at which it occurs. Common symptoms include:

Abdominal pain or tenderness
Abdominal distension
Signs of shock (e.g., low blood pressure, rapid heart rate, dizziness)
Referred pain to the shoulder (Kehr's sign), indicating irritation of the diaphragm

Diagnosis[edit | edit source]

Diagnosis of hemoperitoneum involves a combination of clinical assessment and diagnostic tests, including:

Physical examination, focusing on abdominal tenderness and signs of internal bleeding
Ultrasound, which can quickly identify free fluid in the abdomen
Computed tomography (CT) scan, offering detailed images of the abdominal organs and potential sources of bleeding
Diagnostic peritoneal lavage (DPL) or Focused Assessment with Sonography for Trauma (FAST) in emergency settings

Treatment[edit | edit source]

Treatment of hemoperitoneum aims to stabilize the patient and address the underlying cause of bleeding. Initial management includes:

Fluid resuscitation to maintain blood pressure and organ perfusion
Blood transfusion if significant blood loss has occurred
Surgery to repair the source of bleeding, which may involve laparotomy or laparoscopy
In some cases, angiography with embolization may be used to control bleeding without open surgery

Prognosis[edit | edit source]

The prognosis of hemoperitoneum depends on the cause, the amount of blood loss, and the timeliness of treatment. Early detection and treatment are crucial for a favorable outcome.

Prevention[edit | edit source]

Preventing hemoperitoneum involves minimizing risk factors for the underlying causes, such as using seat belts to prevent injuries from car accidents and managing chronic liver diseases to prevent complications.