Disease relevance of Hemoperitoneum

• The size of the tubal mass created by ectopic pregnancy was predicted precisely (r = .91, P less than .001), and transvaginal sonography enabled detection of hemoperitoneum with a sensitivity of 91% (68 of 75 women) [1].
• Abdominal pain and hemoperitoneum: sole presenting symptoms for "leaking AAA" after endovascular repair [2].
• Midtrimester hemoperitoneum caused by placenta percreta in association with elevated maternal serum alpha-fetoprotein level [3].
• Acute abdomen in systemic lupus erythematosus with spontaneous hemoperitoneum [4].
• OBJECTIVE: To present the first report of massive hemoperitoneum in a case of essential thrombocythemia after transvaginal oocyte retrieval for IVF and review the relevant literature related to the management of patients with this condition [5].

High impact information on Hemoperitoneum

• Recurrent hemoperitoneum reversed by ascorbic acid [6].
• Ruptured corpus luteum with hemoperitoneum [7].
• Acute hemoperitoneum develops in 5-15% of patients with hepatocellular carcinoma requiring transcatheter arterial embolization [8].
• Hemostasis was achieved during emergency surgery for hemoperitoneum by increasing the factor X level to 35 percent with a Factor IX concentrate, followed with infusions of FFP to maintain levels between 10 and 20 percent for 6 days postoperatively [9].
• The associations between the outcome of the treatment and different factors studied (human chorionic gonadotropin (hCG) level, progesterone level, hematosalpinx diameter, hemoperitoneum volume and mode of MTX administration) were analyzed [10].

Chemical compound and disease context of Hemoperitoneum

• Spontaneous hemoperitoneum from brodifacoum overdose [11].
• A 19-year-old man with paroxysmal nocturnal hemoglobinuria treated for 3 years with Methandienone was admitted to the hospital with hemoperitoneum due to the rupture of an hepatic tumor [12].
• Acute hemoperitoneum developed after percutaneous ethanol injection therapy, but he was treated conservatively with blood transfusion, and recovered [13].
• More patients in the methotrexate failure group (45.5%) had hemoperitoneum of > 500 mL than those in the primary laparoscopy group (1.5%; P < .001) [14].
• Lesson learnt: don't prescribe heparin for hemoperitoneum [15]!

Biological context of Hemoperitoneum

• We report a case of hemoperitoneum in the second trimester due to placenta percreta which was associated with an elevated maternal serum alpha-fetoprotein [3].

Anatomical context of Hemoperitoneum

• Emergent exploratory laparotomy revealed a normal appendix, a ruptured nodule located at the serosal surface of the terminal ileum with hemoperitoneum, and ruptured hepatocellular carcinoma at the junction of segments 4 and 8 of the liver [16].

Gene context of Hemoperitoneum

• Autosomal dominant polycystic liver disease as an etiology for hemoperitoneum during CCPD [17].
• In patients with hemoperitoneum, celiac angiography is advocated for diagnosis when immediate surgery is not indicated [18].
• The classic presentation is a triad of bleeding, abdominal distension, and hemoperitoneum [19].
• It has been shown to be as accurate as DPL and computed tomography (CT) in the detection of hemoperitoneum following abdominal trauma [20].
• CONCLUSION: Treatment with methotrexate is effective and safe in the presence of these criteria: patient hemodynamically stable, absence of tubal rupture sign and hemoperitoneum, an adnexal mass with a diameter < or = 5 cm, an amenorrhea < or = 6 weeks and HCG levels < or = 10,000 mIU/ml [21].

Analytical, diagnostic and therapeutic context of Hemoperitoneum

• We describe three southern African black men who presented with an acute hemoperitoneum after blunt trauma to the abdomen, and in whom a moderate-size hepatocellular carcinoma was found at laparotomy to have ruptured [22].
• A 37-year-old woman presented with left lower quadrant pain and vaginal spotting 1 month after hysterectomy and right salpingo-oophorectomy, which were performed for hemoperitoneum related to a ruptured corpus luteum [23].
• This rare presentation of a malignancy uncommon in North America leads to a discussion of the differential diagnosis of acute hemoperitoneum and a review of the literature on acute hemoperitoneum and HCC [24].

References