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At least 19 recordsLinked to original sources
PubMed1992

Hemoperitoneum complicating chronic peritoneal dialysis: single-center experience and literature review.

Hemoperitoneum is a well-recognized, if uncommon, complication of chronic peritoneal dialysis. In this review of 424 patients maintained on peritoneal dialysis at a single center during an 11-year period, 26 patients (6.1%) developed one or more episodes of hemoperitoneum. Three patients had hemoperitoneum on two separate occasions with different etiologies. One additional patient was seen on a hospital consultative service. Three types of bleeding episodes were observed. Twenty-one of 30 (70%) were benign, consisting of pink-tinged dialysate with little clinical consequence (group 1). Three (10%) consisted of minor hemoperitoneum associated with significant intra-abdominal pathology (group 2), and six (20%) required active intervention (group 3). The most frequent cause of hemoperitoneum was bleeding related to menstruation or ovulation; hemoperitoneum was more common in women than in men. Two patients had hemoperitoneum occurring after more than 6 years on dialysis. In both, the etiology was sclerosing peritonitis, an association not previously noted. The less common etiologies of hemoperitoneum encountered in our patients were similar to those in reports from other centers and are compiled here.

Female↗
PubMed1992

[Ultrasonographic finding of hemoperitoneum and indication for laparotomy in blunt abdominal trauma].

The usefulness of the ultrasonography (US) for the indication for laparotomy was evaluated. I analyzed 200 blunt trauma patients who took US exams at my emergency center immediately after admission. Ninety-five percent of patients with hemodynamic instability, whose hemoperitoneum was revealed by US, underwent laparotomy. No negative laparotomy was performed in those patients. Only 5.4% of US hemoperitoneum-negative patients with stable hemodynamics required laparotomy because of peritoneal irritation or the evidence of traumatic diaphragmatic hernia. US hemoperitoneum-positive patients with stable hemodynamics were treated selectively, and 46% of such patients eventually underwent laparotomy, depending on findings of serial US, CT, DPL and Intravenous urogram. In two third of them laparotomy was indicated because of serial US showing the appearance or increase in hemoperitoneum. The maximum width of echo free space in Morison's pouch became more than 10 mm in the all exams when the laparotomy was indicated. I believe that US finding of hemoperitoneum should be an integral part of evaluating laparotomy indications in blunt abdominal trauma.

Abdominal Injuries↗
PubMed1992

[A case of MCTD patient with recurrent hemoperitoneum receiving CAPD who had a successful recovery with an increase in steroids].

A-48-year-old man with end stage renal disease due to MCTD started CAPD in February 1988. He also had been treated by steroid therapy which was gradually decreased. He had seven hemoperitoneum episodes for ten months and two years since starting CARD. None of episodes were associated with CAPD catheter nor bacillus peritonitis. While he had had long term hemoperitoneum episode in March 1989, he was received no steroid and had leucopenia and low compliments. Therefore he was treated by steroids again. He had no hemoperitoneum episodes for seventeen months since re-steroid therapy. And he recovered from leucopenia and low compliments. It seems that the mechanisms of hemoperitoneum are due to immunological abnormality associated with MCTD.

Hemoperitoneum↗
PubMed1990

Nonoperative management of major blunt liver injury with hemoperitoneum.

We evaluated the role of nonoperative therapy in 16 patients with blunt multisystem trauma, hemodynamic stability following resuscitation, and major lobar liver injury; the patients were treated with a protocol of intensive care unit observation and computed tomographic scanning to identify and follow up the hepatic lesion. Computed tomographic scans showed right-lobe or bilobar liver lacerations and/or subcapsular hematomas in all patients and associated hemoperitoneum in 8 patients. Exploration was required in 2 patients; both were found to have a hemoperitoneum and a nonbleeding liver laceration. There were no deaths. Patients with hemoperitoneum requiring transfusion had significantly greater injury severity scores and longer intensive care unit and hospital stays. The major advantage of a nonoperative approach is the opportunity to stabilize major extra-abdominal (particularly head) injuries as the first priority. Unstable hemodynamics, abdominal distension, and falling hematocrit are indications for prompt exploration. Nonoperative care of these injuries requires a strict treatment protocol.

Adolescent↗
PubMed1991

Emergency center ultrasonography in the evaluation of hemoperitoneum: a prospective study.

The reliability of ultrasonographic detection (US) of hemoperitoneum in blunt abdominal trauma was evaluated in a prospective study of 72 patients. Independent of the examiner, sensitivity, specificity, and accuracy were, respectively, 86.7%, 100%, and 97.2%. Laparotomy was indicated in 76.9% of US hemoperitoneum-positive cases. No negative laparotomies were performed in this study group. If hemoperitoneum is revealed in US and vital signs are unstable, we think laparotomy is indicated. We believe that US in an emergency center is a quick, safe screening method in the evaluation of blunt abdominal trauma. US might take over a great part of the role of diagnostic peritoneal lavage.

Abdominal Injuries↗
PubMed1990

Hemoperitoneum as a result of coital injury without associated vaginal injury.

Hemoperitoneum as a result of coital injury without associated vaginal injury is an extremely rare entity, and evidence by only five cases that have been reported in the medical literature to date. We report five additional cases encountered in two medical centers. Two of these were ruptured corpus luteum cysts, one was a laceration of the round ligament, another was a laceration of an ovary, and the fifth was rupture of a serous cystadenoma. This diagnosis should be considered in patients with hemoperitoneum after coitus.

Adult↗
PubMed1975

Thoracic aortic clamping for prophylaxis against sudden cardiac arrest during laparotomy for acute massive hemoperitoneum.

Experimental studies in dogs were performed to develop a model simulating clinical patients with penetrating wounds of the major abdominal vessels who develop sudden cardiac arrest following laparotomy and decompression of an acute massive hemoperitoneum. Hypovolemic dogs with a saline-distended tense abdomen and major arterial bleeding after laparotomy develop a sudden deterioration of cardiac function despite raped blood infusion, thus simulating the clinical problem. However, thoracic aortic occlusion before laparotomy and until control of distal arterial bleeding prevented such a cardiovascular collapse. Increased intra-abdominal pressure it itself was determental to cardiovascular function; its sudden release by laparotomy was associated with an improvement in cardiovascular function. An approach of thoracic aortic control before laparotomy is recommended in patients with acute massive hemoperitoneum who remain hypotensive before laparotomy.

Abdominal Injuries↗
PubMed1991

[Post-traumatic hemoperitoneum: a rare complication of peritoneal splenosis].

Peritoneal splenosis is a frequent condition after traumatic spleen fracture, which, given that it is usually asymptomatic, is often not diagnosed unless a laparotomy is performed for some other reason. The case is presented of a 9 year old boy splenectomized a few years earlier because of traumatism, who again suffers abdominal injury with the development of hemoperitoneum, observing during surgery multiple splenosis foci disseminated all over the abdominal cavity, some of which present rupture and hemorrhage, constituting the cause of hemoperitoneum.

Abdominal Injuries↗
PubMedDate not supplied

Prevention of hemoperitoneum during ovulation by oral contraceptives in women with type III von Willebrand disease and afibrinogenemia. Case reports.

The follicle ruptures at the time of ovulation and fills with blood, forming a corpus hemorrhagicum. Minor bleeding from the follicle into the abdominal cavity may cause peritoneal irritation and, when it occurs in a patient with a defect of primary hemostasis, hemoperitoneum can occur. Von Willebrand disease and afibrinogenemia are two important bleeding disorders in which both primary hemostasis and coagulation are involved. Bleeding during ovulation is one major clinical complication in women with these disease. We have studied three patients with this hemorrhagic complication. Our data show that oral contraceptives are an effective way to avoid hemoperitoneum.

Adult↗
PubMed1990

[Fallopian tube bilharziasis caused by Schistosoma intercalatum disclosed by hemoperitoneum].

Schistosomiasis due to Schistosoma intercalatumis common in Gabon and, since 1971, Schistosoma haematobium has been found in the south of the country. Genital involvement is infrequent: 0.8 per cent of gynecologic specimens sent to the pathology laboratory and ten of 622 fallopian tube specimens (1.5 per cent). We report an unusual clinical case with hemoperitoneum as the first manifestation: the schistosomal lesion was developed within the tubal serosa, and caused a breach in an arteriole responsible for a 2500 cc hemoperitoneum. Genital lesions preferentially involve the vulva, vagina, and cervix. Involvement of the tubes and ovaries is less common and seems to have an incidence on fertility only if bacterial superinfections cause adhesions around the tubes and ovaries. Genital schistosomiasis is usually asymptomatic. Ectopic pregnancies and infertility may occur.

Adult↗
PubMed1989

[Double gastric leiomyosarcoma revealed by a hemoperitoneum].

The authors report a complicated leiomyosarcoma gastric case with hemoperitoneum. The exploratory laparotomy reveals an hemoperitoneum constituted from both gastric tumors. One was localised in the antrum and was encapsulated, the other in the cardia and had an encephaloid and necrotized core. The pathological examination of the total gastrectomy piece is consistent with a double gastric localisation of a leiomyosarcomosis. 5 years after the initial operation, the patient developed hepatic metastases. A review of literature allows the authors to make the point of this disease.

Adolescent↗
PubMed1979

Hemoperitoneum from a ruptured varix in cirrhosis. Case report and literature review.

A cirrhotic patient with hemoperitoneum is presented. The diagnosis of ruptured retroperitoneal varices was made at laparotomy and the patient becomes the second reported case to survive hospitalization for bleeding intra-abdominal varices. The formation of varices as a consequence of portal hypertension is discussed; the differential diagnosis and evaluation of hemoperitoneum is considered and the seven previously reported cases of intra-abdominal variceal hemorrhage are reviewed.

Hemoperitoneum↗
PubMed1992

Hemoperitoneum in the setting of metastatic cancer to the liver. A report of two cases with review of the literature.

Two cases of hemoperitoneum occurring as a result of hepatic rupture due to metastatic neoplasms are presented. They represent examples of a striking and devastating but fortunately uncommon entity. The variety of primary neoplastic sites is diverse. Several possible mechanisms have been put forward to explain the event of hepatic rupture itself. Finally, it is important to note the uniformly poor survival rates following hepatic rupture despite therapy.

Adenocarcinoma↗
PubMed1990

Ruptured mycotic pseudoaneurysm of the gastroduodenal artery presenting with hemoperitoneum and subcapsular liver hematoma.

We report a case of a patient with mycotic pseudoaneurysm of the gastroduodenal artery who presented with hemoperitoneum and subcapsular hematoma of the liver. The diagnosis was established with contrasted abdominal CT scanning. Visceral angiography was not needed. Prompt recognition and surgical intervention led to a favorable outcome. Pseudoaneurysm of visceral vessels is an uncommon disease process, and to our knowledge, this is the first reported case that has presented with free blood in the peritoneal cavity and beneath the liver capsule. This case may also represent a rare complication of therapeutic ERCP procedures. Mycotic aneurysm or pseudoaneurysm of visceral vessels may develop from bacteremia and its dissection or rupture should be suspected in patients presenting with sepsis and abdominal pain.

Aged↗