Hemoperitoneum is the medical term for a specific type of internal bleeding, where the patient presents with a pooling of blood in the peritoneal cavity. This cavity is a small area located between the inner wall of the abdomen and the internal abdominal organs. The condition can be a medical emergency, so anyone displaying symptoms should seek medical attention immediately.
There are various factors or conditions that can cause hemoperitoneum, including ectopic pregnancy, a ruptured organ or blood vessel, or physical trauma to the region. Among his many scientific publications, Ali Ghoz has co-authored a report on hemoperitoneum secondary to rupture of cystic artery pseudoaneurysm, outlining an unusual case and detailing the treatment methods used.
The PDF attachment explains more about pseudoaneurysms and how they differ from true aneurysms.
There are several methods that doctors can use to diagnose hemoperitoneum, with several tests that can be performed quickly if the condition is suspected. In emergency cases, a FAST test may be used. This stands for Focused Assessment with Sonography for Trauma and involves a sonogram to discover whether there is a build-up of blood accumulating in the abdominal cavity.
For non-emergency cases, tests may begin with a simple physical examination of the abdomen and pelvic region, so the doctor can determine the source of the pain manually. Hemoperitoneum can also be diagnosed by a CT scan, or the doctor may conduct a paracentesis. You can find out more about paracentesis in the embedded short video.
The treatment options for hemoperitoneum depend on what is causing the bleeding. In cases of ectopic pregnancy, if it is diagnosed early enough, it can be conservatively managed with medication such as methotrexate. The treatment will depend on various factors including how quickly the blood is accumulating. In most cases, a laparotomy or laparoscopic surgery will be used to close the fallopian tube.
Where the underlying cause is something else, most often the treatment required will be emergency surgery. Emergency room doctors will carry out the diagnostic procedure and perform surgery to remove the blood already accumulated, as well as discover where it is coming from. If it is from a ruptured spleen, it will be removed during surgery. If a ruptured blood vessel is the cause, it will be tied off to prevent more blood loss. If the liver is found to be the cause of the bleeding, blood-clotting drugs may be prescribed.
Complications from Untreated Hemoperitoneum
If hemoperitoneum is suspected, treatment will usually occur immediately as the complications from untreated hemoperitoneum can be severe. Diagnosis and treatment will take place quickly in the emergency room. The peritoneal cavity is unique within the human body as it has the capacity to hold almost the entire volume of circulating blood in the average person. Blood can accumulate there fast which can cause severe complications including shock from blood loss.
Patients may quickly become unresponsive and the blood loss can be severe enough to lead to death. The symptoms can escalate extremely quickly, although they can be hard to identify unless the underlying cause is an accident or blunt trauma that results in a visit to the emergency room. The symptoms of hemoperitoneum can be found in the infographic attachment to this post.
Causes of Hemoperitoneum
Ectopic pregnancy is the most common cause of hemoperitoneum, but the condition can also be caused by blunt trauma to the internal organs in the pelvic region. This kind of trauma could occur in a car accident, or due to a sports injury.