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At least 19 recordsLinked to original sources
PubMed1992

[Ultrasonographic finding of hemoperitoneum and indication for laparotomy in blunt abdominal trauma].

The usefulness of the ultrasonography (US) for the indication for laparotomy was evaluated. I analyzed 200 blunt trauma patients who took US exams at my emergency center immediately after admission. Ninety-five percent of patients with hemodynamic instability, whose hemoperitoneum was revealed by US, underwent laparotomy. No negative laparotomy was performed in those patients. Only 5.4% of US hemoperitoneum-negative patients with stable hemodynamics required laparotomy because of peritoneal irritation or the evidence of traumatic diaphragmatic hernia. US hemoperitoneum-positive patients with stable hemodynamics were treated selectively, and 46% of such patients eventually underwent laparotomy, depending on findings of serial US, CT, DPL and Intravenous urogram. In two third of them laparotomy was indicated because of serial US showing the appearance or increase in hemoperitoneum. The maximum width of echo free space in Morison's pouch became more than 10 mm in the all exams when the laparotomy was indicated. I believe that US finding of hemoperitoneum should be an integral part of evaluating laparotomy indications in blunt abdominal trauma.

Abdominal Injuries↗
PubMed1975

Thoracic aortic clamping for prophylaxis against sudden cardiac arrest during laparotomy for acute massive hemoperitoneum.

Experimental studies in dogs were performed to develop a model simulating clinical patients with penetrating wounds of the major abdominal vessels who develop sudden cardiac arrest following laparotomy and decompression of an acute massive hemoperitoneum. Hypovolemic dogs with a saline-distended tense abdomen and major arterial bleeding after laparotomy develop a sudden deterioration of cardiac function despite raped blood infusion, thus simulating the clinical problem. However, thoracic aortic occlusion before laparotomy and until control of distal arterial bleeding prevented such a cardiovascular collapse. Increased intra-abdominal pressure it itself was determental to cardiovascular function; its sudden release by laparotomy was associated with an improvement in cardiovascular function. An approach of thoracic aortic control before laparotomy is recommended in patients with acute massive hemoperitoneum who remain hypotensive before laparotomy.

Abdominal Injuries↗
PubMed1979

Hemoperitoneum from a ruptured varix in cirrhosis. Case report and literature review.

A cirrhotic patient with hemoperitoneum is presented. The diagnosis of ruptured retroperitoneal varices was made at laparotomy and the patient becomes the second reported case to survive hospitalization for bleeding intra-abdominal varices. The formation of varices as a consequence of portal hypertension is discussed; the differential diagnosis and evaluation of hemoperitoneum is considered and the seven previously reported cases of intra-abdominal variceal hemorrhage are reviewed.

Hemoperitoneum↗
PubMed1976

The role of thoracic aortic occlusion for massive hemoperitoneum.

Forty patients with abdominal injury and massive hemoperitoneum had left thoracotomy and thoracic aortic occlusion. All 40 patients had tense abdominal distention and 37 patients were hypotensive at the time of skin incision despite aggressive resuscitation with blood and crystalloid solution. Laparotomy was performed initially in 11 patients; seven patients had sudden cardiovascular collapse as the abdominal wall tamponade was released and four patients remained hypotensive. With thoracotomy and thoracic aortic occlusion six of the 11 patients were resuscitated and had their injuries repaired. Thoracotomy and thoracic aortic occlusion were performed before laparotomy in 29 patients: seven patients remained hypotensive and expired; blood pressure was promptly restored in 22 patients and 11 of them survived the operative procedure. Left thoracotomy and thoracic aortic occlusion, before laparotomy, is offered as an alternative approach in patients with refractory hypotension and tense, abdominal distention. This technique aids in rapid restoration of vital signs, insures continued perfusion of the brain and myocardium, provides proximal arterial control, and prevents sudden cardiac arrest as the abdominal wall tamponade is released.

Abdominal Injuries↗
PubMed1975

Ruptured corpus luteum with hemoperitoneum.

Rupture of the corpus luteum in a young woman can cause massive hemoperitoneum, seen as free fluid in the flanks and pelvis on abdominal films. Radiographic examination alone cannot distinguish hemorrhage due to a ruptured corpus luteum or ectopic pregnancy from pus due to a ruptured appendix or a tubo-ovarian abscess; however, the presence of nonclotting blood on culdocentesis excludes abdominal sepsis. If these symptoms and findings occur during the latter half of the menstrual cycle in a young woman of low parity who has a normal menstrual history and a negative pregnancy test, a ruptured corpus luteum is a more likely diagnosis than ectopic pregnancy.

Abdomen↗
PubMed1975

[Autotransfusion in acute hemoperitoneum].

This procedure is well known, there were 2 000 cases reported in the literature with a very small number of complications. Is autotransfusion really efficacious? According to the author's results in 9 cases of hemoperitoneum, the red cells obtained by this method are quantitatively valid, but hemolysis starts early (6 hours) and the disappearance of the platelets and coagulation factors occurs even more early (2 hours). However, clinical tolerance is perfect, thus confirming the good experimental results obtained in animals. The true limits are hemolysis and the risk of contamination but, with appropriate apparatus and precise indications, and unsoiled blood, less than 24 hours old, autotransfusion is a good method which may provide a solution in certain emergencies.

Abdominal Injuries↗
PubMedDate not supplied

[Penetrating wound of the right ventricle associated with hemoperitoneum of hepatic origin].

The authors discuss, in connection with a penetrating wound of the right ventricle induced with a knife, associated to hemoperitoneum (1 400 ml) following transfixiant hepatic wound on the importance of a complete diagnosis in complex trauma. In such type of trauma, the approach of thoracic lesions must be independent of the treatment of abdominal ones, in view of the prevention of contamination of the thoracic cavity. For the time being digital obstruction of penetrating heart wounds is the least traumatic and the most efficient modality to stop hemorrhage, facilitating at the same time, the performance of cardiography.

Adult↗
PubMed1979

[The indications for laparoscopy in the diagnosis of hemoperitoneum (author's transl)].

In consideration of the well-known difficulties associated with the precise diagnosis of hemoperitoneum, the authors offer their personal experience in support of laparoscopy as a diagnostic aid in such dramatic events. They review 23 cases of emergency laparoscopy performed in the First Institute of Clinical Surgery of the University of Catania between January 1978 and January 1979. Recalling that the procedure was applied to patients as young as 3 and as old as 80, they confirm the opinion expressed from other quarters, namely that laparoscopy is an essentially harmless and rapid procedure conducive to very accurate diagnosis in view of appropriate planning of therapeutic treatment.

Adult↗
PubMed1975

Hemoperitoneum from liver cell adenoma in a patient on oral contraceptives.

A case of hemoperitoneum from ruptured benign liver cell adenoma in a young woman with a long history of oral contraceptive use is presented. The importance of recognizing the cause of this intra-abdominal emergency is stressed, and comment is made about the entity occurring in women on contraceptive drugs.

Adult↗
PubMed1979

[Acute abdomen due to hemoperitoneum as the first manifestation of a liver tumor. Report of four cases (author's transl)].

Four cases of spontaneous acute hemoperitoneum due to rupture of a liver tumor are presented. The resulting acute abdomen was the first manifestation of the neoplasia. The four tumors corresponded histopathologically to a cavernous hemangioma, a bening adenoma related to anabolizing androgens, and two hepatocarcinomas in cirrhotic livers. All of the patients presented abdominal pain and shock, the characteristics of which are described in this report. One of the patients died due to cardiac arrest before surgical treatment. Emergency surgery was performed on the other three, consisting of left hepatic lobectomy and ligature of the hepatic artery for the hemengioma, and segmented hepatectomy for the adenoma and the hepatocarcinoma. Only the patient with benign tumor survived. Lastly, the authors review the literature, commenting on the clinical, physiopathologic, therapeutic, and prognostic aspects.

Abdomen, Acute↗
PubMed1979

Massive spontaneous hemoperitoneum due to rupture of visceral branches of the abdominal aorta.

Review of 153 cases of massive spontaneous hemoperitoneum following visceral arterial rupture showed that 94% of all young women and 100% of all pregnant women had ruptured congenital splenic artery aneurysms at the time of hemorrhage, whereas young males bled from a variety of sources. Individuals who were 45 years old or older bled either from lesions of the celiac axis or its branches (66%) or from arterial mesenteric system lesions (34%). Only 22% of the older individuals of either sex bled from splenic artery sources. Arterial hypertension was present in 40% and previous or simultaneous intracranial hemorrhage occurred in 9% of the older patients. There were no survivors among those in whom the bleeding source was not operatively controlled. With operation, 79% of the younger patients and 57% of the older ones survived. Results emphasize the high mortality of visceral artery rupture with intraperitoneal bleeding. Prophylactic excision is advised for all complicated aneurysms regardless of age and all uncomplicated aneurysms in healthy individuals, especially in fertile or pregnent women.

Adult↗
PubMed1977

[Hemoperitoneum in the newborn infant].

Among 46272 term and preterm newborns 6 cases (0,13%) of massive intraabdominal hemorrhages could be found. The origin of hemorrhage was in 5 cases the liver. Premature newborns with severe respiratory distress had the main incidence (4 cases). Organic lesions were seen in 2 cases only and other traumatic causes could not be detected. Therefore, the term "abdominal birth injury" should in such cases be replaced by "Neonatal hemoperitoneum".

Adult↗
PubMed1975

[Idiopathic hemoperitoneum in young women].

We present three cases of idiopathic hemoperitoneum or abdominal apoplexy in young women. At laparotomy a large quantity of blood was found in the abdomen in each patient, but active bleeding had stopped and the site of its origin was not established. A well-developed corpus luteum which was intact was found, of pregnancy in one case and of the progestationl phase in the two others. In all three cases the abdomen was closed without hemostasis being carried out. Recovery was rapid but the young woman who was pregnant aborted later. Etiology and the relationship of this syndrome with the state of pregnancy or the progestational phase are discussed as well as prognosis and the management.

Abortion, Spontaneous↗