Skip to main content

Advertisement

SpringerLink
Log in

Spontaneous hemoperitoneum: a bloody mess

  • Review Article
  • Published:
Emergency Radiology Aims and scope Submit manuscript

Abstract

Spontaneous hemoperitoneum may be a life-threatening occurrence. It most frequently presents with acute abdominal pain. Computed tomography (CT) is the most commonly used modality in the initial work up of these patients, but sonography and magnetic resonance imaging (MRI) play a role in the diagnosis. The etiology is varied, yet may be broadly classified into gynecologic, hepatic, splenic, vascular, and coagulopathic causes. This review will describe the common imaging findings of spontaneous hemoperitoneum, as it presents through the emergency room, and will detail the underlying causes and significance of spontaneous hemoperitoneum.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10

Similar content being viewed by others

References

  1. Miele V, Andreoli C, Cortese A et al (2002) Hemoperitoneum following ovarian cyst rupture: CT usefulness for the diagnosis. Radiol Med 104:316–321

    PubMed  Google Scholar 

  2. Huang PH, Tsai KB, Su JH (2003) Hemorrhagic corpus luteum cyst torsion in term pregnancy: a case report. Kaohsiung J Med Sci 19:75–78

    Article  PubMed  Google Scholar 

  3. Teng SW, Tseng JY, Chang CK et al (2003) Comparison of laparoscopy and laparotomy in managing hemodynamically stable patients with ruptured corpus luteum with hemoperitoneum. J Am Assoc Gynecol Laparosc 10:474–477

    Article  PubMed  Google Scholar 

  4. Farhi J, Dicker D, Ben-Rafael Z (1993) Leiomyosarcoma presenting as spontaneous hemoperitoneum. Int J Gynecol Obstet 40:249–250

    Article  CAS  Google Scholar 

  5. Suarez-Penaranda JM, de la Calle MC, Rodriguez-Calvo MS et al (2001) Rupture of liver cell adenoma with massive hemoperitoneum resulting from minor road accident. Am J Forensic Med Pathol 22:275–277

    Article  PubMed  CAS  Google Scholar 

  6. Estebe JP, Malledant Y, Saint-Marc C et al (1988) Spontaneous rupture of an adenoma of the liver during pregnancy. J Chir (Paris) 125:654–656

    CAS  Google Scholar 

  7. Posthuma N, van Eps RS, ter Wee PM (1998) Hemoperitoneum due to hepatocellular adenoma. Perit Dial Int 18:446–447

    PubMed  CAS  Google Scholar 

  8. Pollack H (1979) Spontaneous rupture of a liver adenoma following many years ingestion of an oral contraceptive. Munch Med Wochenschr 121:93–94

    Google Scholar 

  9. Scribano E, Loria G, Ascenti G et al (1996) Spontaneous hemoperitoneum from a giant multicystic hemangioma of the liver: a case report. Abdom Imaging 21:418–419

    Article  PubMed  CAS  Google Scholar 

  10. Corigliano N, Mercantini P, Amodio PM et al (2003) Hemoperitoneum from a spontaneous rupture of a giant hemangioma of the liver: report of a case. Surg Today 33:459–463

    Article  PubMed  Google Scholar 

  11. Becker YT, Raiford DS, Webb L et al (1995) Rupture and hemorrhage of hepatic focal nodular hyperplasia. Am Surg 61:210–214

    PubMed  CAS  Google Scholar 

  12. Kleespies A, Settmacher U, Neuhaus P (2002) Spontaneous rupture of hepatic focal nodular hyperplasia-a rare cause of acute intra abdominal bleeding. Zentralbl Chir 127:326–328

    Article  PubMed  CAS  Google Scholar 

  13. Bagia S, Hewitt PM, Morris DL (2000) Anabolic steroid induced hepatic adenomas with spontaneous haemorrhage in a bodybuilder. Aust N Z J Surg 70:686–687

    Article  PubMed  CAS  Google Scholar 

  14. Chiappa A, Zbar A, Audisio R et al (1999) Ruptured hepatic adenoma in liver adenomatosis: a case report of emergency surgical management. Hepatogastroenterology 46:1942–1943

    PubMed  CAS  Google Scholar 

  15. Ades CJ, Strutton GM, Walker NI et al (1989) Spontaneous rupture of the liver associated with amyloidosis. J Clin Gastroenterol 11:85–87

    Article  PubMed  CAS  Google Scholar 

  16. Mukhopadhya A, Raghuram L, Justus A et al (2004) Trans catheter hepatic artery embolization for spontaneous rupture of amyloid liver. Indian J Gastroenterol 23:26–28

    PubMed  Google Scholar 

  17. Di Martino G (1993) The emergency surgical treatment of hemoperitoneum due to the spontaneous rupture of a hepatocarcinoma in a cirrhotic liver. Ann Ital Chir 64:83–85

    PubMed  Google Scholar 

  18. Alonso M, Reyes G, Galera MJ et al (1991) Hemoperitoneum cased by spontaneous rupture of hepatocarcinoma. A propos of 8 cases. J Chir (Paris) 128:130–132

    CAS  Google Scholar 

  19. Fidas-Kamini A, Busuttil A (1987) Fatal haemoperitoneum from ruptured hepatic metastases from testicular teratomas. Br J Urol 60:80–81

    Article  PubMed  CAS  Google Scholar 

  20. Wong KT, Khir AS, Noori S et al (1994) Fatal haemoperitoneum due to rupture of hepatic metastasis from renal cell carcinoma. Aust N Z J Surg 64:128–129

    PubMed  CAS  Google Scholar 

  21. Mittleman RE (1987) Hepatic rupture due to metastatic lung carcinoma. Am J Clin Pathol 88:506–509

    PubMed  CAS  Google Scholar 

  22. Erb RE, Gibler WB (1989) Massive hemoperitoneum following rupture of hepatic metastasis from unsuspected choriocarcinoma. Am J Emerg Med 7:196–198

    Article  PubMed  CAS  Google Scholar 

  23. Felici E, Mansueto G, Imperato L et al (1985) A case of hemoperitoneum caused by the spontaneous rupture of hepatic metastasis of Wilm’s tumor. Minerva Chir 40:1001–1003

    PubMed  CAS  Google Scholar 

  24. Tung CF, Chang CS, Chow WK et al (2002) Hemoperitoneum secondary to spontaneous rupture of metastatic epidermoid carcinoma of liver: case report and review of the literature. Hepatogastroenterology 49:1415–1417

    PubMed  Google Scholar 

  25. Urdaneta LF, Nielsen JV (1986) Massive hemoperitoneum secondary to spontaneous rupture of hepatic metastases: report of two cases and review of the literature. J Surg Oncol 31:104–107

    Article  PubMed  CAS  Google Scholar 

  26. Chen ZY, Qi QH, Dong ZL (2002) Etiology and management of hemorrhage in spontaneous liver rupture: a report of 70 cases. World J Gastroenterol 8:1063–1066

    PubMed  Google Scholar 

  27. Al Mashat FM, Sibiany AM, Kashgari AH, Maimani AA, Al-Radi AO, Ahmad JE (2002) Spontaneous rupture of hepatocellular carcinoma. Saudi Med J 23:866–870

    Google Scholar 

  28. Cavallari A, Vivarelli M, Bellusci R, De Raffaele E, Nardo B, Gozzetti G (1994) The intraperitoneal bleeding of hepatocellular carcinoma. Chir Ital 46:45–49

    PubMed  CAS  Google Scholar 

  29. Burke M, Opeskin K (2000) Spontaneous rupture of the liver associated with a primary angiosarcoma: case report. Am J Forensic Med Pathol 21:134–137

    Article  PubMed  CAS  Google Scholar 

  30. Slovacek R, Miculka P (1999) Angiosarcoma of the liver as a cause of massive hemoperitoneum. Rozhl Chir 78:99–101

    PubMed  CAS  Google Scholar 

  31. Bellaiche G, Habib E, Baledent F et al (1998) Hemoperitoneum due to spontaneous splenic rupture: a rare complication of primary cytomegalovirus infection. Gastroenterol Clin Biol 22:107–108

    PubMed  CAS  Google Scholar 

  32. Daybell D, Paddock CD, Zaki SR et al (2004) Disseminated infection with Bartonella henselae as a cause of spontaneous splenic rupture. Clin Infect Dis 39:21–24

    Article  Google Scholar 

  33. Khan AZ, Escofet X, Roberts KM et al (2003) Spontaneous splenic rupture-a rare complication of amyloidosis. Swiss Surg 9:92–94

    Article  PubMed  CAS  Google Scholar 

  34. Paulvannan S, Pye JK (2003) Spontaneous rupture of a normal spleen. Int J Clin Pract 57:245–246

    PubMed  CAS  Google Scholar 

  35. Janicki TI, David LJ, Skaf R (2002) Massive and acute hemoperitoneum due to rupture of the uterine artery by erosion from an endometriotic lesion. Fertil Steril 78:879–881

    Article  PubMed  Google Scholar 

  36. Lehn E, Laqbaqbi A, Nerine JA (1988) A rare cause of hemoperitoneum: spontaneous rupture of a hepatic artery, the site of septic thrombosis. Presse Med 17:415–417

    PubMed  CAS  Google Scholar 

  37. Leaute F, Frampas E, Mathon G et al (2002) Massive hemoperitoneum from rupture of an intra peritoneal varices. J Radiol 83:1775–1777

    PubMed  CAS  Google Scholar 

  38. Moreno JP, Pina R, Rodriguez F et al (2002) Spontaneous hemoperitoneum caused by intra abdominal variceal rupture in a patient with liver cirrhosis. Clinical case. Rev Med Chile 130:433–436

    PubMed  Google Scholar 

  39. Chu EC, Chick W, Hillebrand DJ et al (2002) Fatal spontaneous gallbladder variceal bleeding in a patient with alcoholic cirrhosis. Dig Dis Sci 47:2682–2685

    Article  PubMed  Google Scholar 

  40. Vallalta Morales M, Cano B, Morato Aldea C et al (2004) Hemoperitoneum secondary to spontaneous rupture of the umbilical vein. Gastroenterol Hepatol 27:414–416

    Article  PubMed  CAS  Google Scholar 

  41. Ghobrial MW, Karim M, Mannam S (2002) Spontaneous splenic rupture following the administration of intravenous heparin: case report and retrospective case review. Am J Hematol 71:314–317

    Article  PubMed  Google Scholar 

  42. Pissas A, Danel V, Finet P (1985) A rare complication of anticoagulants: hemoperitoneum caused by gallbladder rupture. Review of the literature a propos of a case. J Chir (Paris) 122:235–245

    CAS  Google Scholar 

  43. Dafopoulos K, Galazios G, Georgadakis G et al (2003) Two episodes of hemoperitoneum from luteal cysts rupture in a patient with congenital factor X deficiency. Gynecol Obstet Investig 55:114–115

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Boston VA Healthcare System, 1400 VFW Parkway, West Roxbury, MA, 02132, USA

    Brian C. Lucey

  2. Division of Body Imaging, Department of Radiology, Boston University Medical Center, 88 East Newton Street, Atrium 2, Boston, MA, 02118, USA

    Jose C. Varghese, Stephan W. Anderson & Jorge A. Soto

Authors
  1. Brian C. Lucey
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jose C. Varghese
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Stephan W. Anderson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jorge A. Soto
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Brian C. Lucey.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lucey, B.C., Varghese, J.C., Anderson, S.W. et al. Spontaneous hemoperitoneum: a bloody mess. Emerg Radiol 14, 65–75 (2007). https://doi.org/10.1007/s10140-007-0594-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10140-007-0594-0

Keywords

Search

Navigation