Hemoperitoneum

Hemoperitoneum refers to the presence of blood within the peritoneal cavity, the space in the abdomen that surrounds the abdominal organs. This condition is typically a medical emergency, as it can result from trauma, surgical complications, or spontaneous rupture of abdominal structures. The accumulation of blood can lead to hypovolemic shock, a life-threatening drop in blood pressure due to severe blood loss, if not promptly identified and treated.

Common causes of hemoperitoneum include blunt or penetrating abdominal trauma, such as from motor vehicle accidents or stab wounds. Other potential sources include ruptured abdominal aortic aneurysms, liver or spleen injuries, ectopic pregnancies, or complications from abdominal surgeries. In some cases, it may arise from bleeding disorders or tumors that invade abdominal organs.

Symptoms often include severe abdominal pain, tenderness, rigidity, and signs of shock such as rapid pulse, low blood pressure, and pale skin. Physical examination may reveal distension of the abdomen and diminished bowel sounds. Diagnostic evaluation typically involves imaging studies such as computed tomography (CT) scans, ultrasound, or diagnostic peritoneal lavage to confirm the presence of blood and identify its source.

Treatment depends on the underlying cause but generally requires immediate medical intervention. In cases of trauma, surgical exploration or angiography may be necessary to control bleeding. For non-traumatic causes, such as ruptured ectopic pregnancies, surgical or interventional radiology techniques may be employed. Supportive care, including fluid resuscitation and blood transfusions, is often provided to stabilize the patient until definitive treatment can be administered.

Prognosis varies based on the severity of blood loss and the promptness of diagnosis and treatment. Early recognition and intervention significantly improve outcomes, emphasizing the importance of clinical suspicion and rapid diagnostic evaluation in suspected cases of hemoperitoneum.