Hemoperitoneum in cirrhotic patients in the absence of abdominal trauma

Aseni, Paolo; Domenico, Sandro Luigi Di; Barbosa, Fernando Policarpo; Rampoldi, Antonio; Berry, Cherisse

doi:10.1080/17474124.2019.1631159

Cited by 3 publications

(4 citation statements)

References 58 publications

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“…In addition, the rupture of large liver cancer and female uterine broids can also lead to the possibility of accidental bleeding in the abdominal cavity [5][6][7]. Aseni P et al [8] observed that spontaneous intraperitoneal bleeding occurred in patients with cirrhotic portal hypertension without traumatic cause. Xu Y et al [9] reported that patients with arteriosclerosis also have the possibility of spontaneous abdominal bleeding.…”

Section: Discussionmentioning

confidence: 99%

“…It has been presented that the case with abdominal apoplexy should underwent auxiliary examination, including blood routine examination, abdominal B-ultrasound, abdominal X-ray, abdominal CT, computed tomography angiography (CTA), angiography, intervention, etc [3][4][5][6][7][8][9][10][11]. Surgeons often choose different treatment measures for abdominal apoplexy, as follows: 1.…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic Treatment of The Gastro-Omental Hemangioma Hemorrhage: 2 Cases Report And Review of The Literature

Yin

Liu

Feng

et al. 2022

Preprint

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Background: Spontaneous hemorrhage of gastro-omental hemangioma is a rare disease. Such patients generally have no medical history of recent abdominal trauma, abdominal surgery, anticoagulation or systemic vascular disease. Treatment strategy of this disease variates along with its development. In the acute circumstances, surgery is somehow the first priority. Among them, laparoscopic treatment should be the most frequently considered option in the large general hospital, however, such cases are rarely reported until now.Case presentation: The present report enrolled two cases admitted with upper abdominal pain. Subsequent abdominal computed tomography (CT) scan revealed masses alongside the greater curvature of the stomach. Laparoscopic surgeries were conducted immediately and the postoperative pathological examination suggested ruptured omental hemangioma with thrombosis. Both two patients recovered smoothly after surgery, and no obvious abnormalities were complained in the follow-up period.Conclusions: Clinicians should consider the possibility of spontaneous rupture of gastro-omental hemangioma in patients with abdominal stroke. The center of medical institutions with mature technology and equipment can perform laparoscopic treatment to minimize surgical trauma and promote rapid recovery of the cases with abdominal apoplexy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Laparoscopic Treatment of The Gastro-Omental Hemangioma Hemorrhage: 2 Cases Report And Review of The Literature

Yin

Liu

Feng

et al. 2022

Preprint

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“…However, recent studies have demonstrated how unenhanced CT does not improve the diagnosis of hemoperitoneum and could expose patients to an unnecessary radiation dose [ 89 ]. The multi-phase protocol gives more information about tumoral vascularization and has a key role in the identification of active hemorrhage [ 90 , 91 ]. Therefore, a CECT scan is the best procedure to identify intra-abdominal hemorrhage, especially when the bleeding rate is low.…”

Section: Ct Findingsmentioning

confidence: 99%

Spontaneously Ruptured Hepatocellular Carcinoma: Computed Tomography-Based Assessment

et al. 2023

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Spontaneously ruptured hepatocellular carcinoma (SRHCC) is an uncommon and life-threatening complication in patients with hepatocellular carcinoma (HCC). It is usually associated with chronic liver disease and has a poor prognosis with a high mortality rate during the acute phase. SRHCC can cause a severe and urgent condition of acute abdomen disease and requires a correct diagnosis to achieve adequate treatment. Clinical presentation is related to the presence of hemoperitoneum, and abdominal pain is the most common symptom (66–100% of cases). Although the treatment approach is not unique, trans-arterial (chemo)embolization (TAE/TACE) followed by staged hepatectomy has shown better results in long-term survival. A multi-phase contrast-enhanced CT (CECT) scan is a pivotal technique in the diagnosis of SRHCC due to its diagnostic accuracy and optimal temporal resolution. The correct interpretation of the main CT findings in SRHCC, such as active contrast extravasation and the sentinel clot sign, is fundamental for a prompt and correct diagnosis. Furthermore, CT also plays a role as a post-operative control procedure, especially in patients treated with TAE/TACE. Therefore, a multi-phase CECT scan should be the diagnostic tool of choice in SRHCC since it suggests an immediate need for treatment with a consequent improvement in prognosis.

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“…Biopsy of the surgical specimen revealed a ruptured early hepatocellular carcinoma (HCC). Sepsis due to primary peritonitis, pulmonary or urinary tract infection, and portal hypertension‐related upper‐gastrointestinal bleeding are the most common causes of shock and ICU admission in cirrhosis 1 . In cirrhotic patients with undifferentiated shock and no indications for abdominal paracentesis, early whole‐body CT with emphasis in ascitic fluid density should be performed to exclude rare causes such as secondary peritonitis and hemoperitoneum from a ruptured intraperitoneal varix or HCC 2…”

Section: Quiz Question: What Is Your Diagnosis?mentioning

confidence: 99%