Hemoperitoneum

Hemoperitoneum is the accumulation in the peritoneal cavity, a life-threatening emergency often requiring urgent surgical intervention.

Overview

Hemoperitoneum occurs when bleeding from abdominal organs or vessels fills the peritoneal space, leading to hypovolemic shock if untreated. It demands rapid diagnosis via ultrasound or CT scan, showing free fluid, alongside clinical signs like abdominal distension and instability.

Causes

Traumatic causes dominate, including blunt injuries from accidents, rupturing the spleen or liver, and penetrating wounds. Non-traumatic etiologies involve ruptured ectopic pregnancy, aortic aneurysm, ovarian cysts, or iatrogenic injury during procedures.

Symptoms

Patients experience severe abdominal pain, distension, tachycardia, hypotension, pallor, nausea, and rebound tenderness. Shoulder-tip pain (Kehr's sign) suggests diaphragmatic irritation from blood.

Diagnosis and Management

FAST ultrasound confirms free fluid; CT provides details. Treatment includes resuscitation, blood transfusion, and surgery (laparotomy or laparoscopy) to control bleeding and evacuate clots. Prognosis improves with early intervention.