Laparoscopic Management of Abdominal Apoplexy

Abstract

Abdominal apoplexy, otherwise known as intraperitoneal idiopathic spontaneous haemorrhage, is a rare condition that presents as a diagnostic dilemma and is associated with high mortality. Symptoms and signs typically are similar to other conditions presenting with upper abdominal peritonitis. Intraabdominal haemorrhage can occur from many different causes, including trauma, iatrogenic, ruptured aneurysm, gynaecological conditions, malignancy, and inflammatory or autoimmune processes. Spontaneous or idiopathic causes are much rarer. Prompt diagnosis and ligation of the bleeding vessel usually result in a good outcome. Most cases described involve males in the fifth and sixth decade of life who present in the setting of hypertension and known atherosclerotic disease and are managed with laparotomy or are diagnosed at autopsy. We present a case of abdominal apoplexy managed laparoscopically in a healthy 20-year-old male with no pre-existing medical conditions. This case highlights the importance to consider abdominal apoplexy in any demographic.

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

“…2. A small number of young people with no de nite cause may also have the risk of abdominal apoplexy [1]. 3.…”

“…The methods of treating this disease usually depend on its development and the the patient's conditions. In the onset or chronic phase, clinic observation and medical treatment are routine options, while in the advanced or acute phase, surgical treatment should be a better choice [1,2]. Recently, there are some case reports on the gastro-omental hemangioma hemorrhage, however, few studies on its laparoscopic treatment [3].…”

Idiopathic Spontaneous Intraperitoneal Hemorrhage due to Rupture of Short Gastric Artery Presenting as Massive Gastrointestinal Bleeding: A Rare Case Presentation and Literature Review

“…Most cases are present in the fifth to seventh decade of life with a 3:1 male to female ratio. In our case, the patient had mild coagulopathy; however, not severe enough to cause spontaneous hemorrhage [ 4 ]. ISIH presents itself with a wide variety of signs and symptoms depending on the containment of hemorrhage and the development of a hematoma.…”

“…Since initially reported, less than 200 cases of ISIH have been described in the literature [ 4 ]. Major risk factors believed to be associated in most cases (80-87%) were the usual causes of atherosclerosis, such as high blood pressure, hyperlipidemia, diabetes, and obesity.…”

“…In patients who do not undertake surgery, mortality has historically come closer to 100%. Nevertheless, prompt surgical intervention decreases the mortality to 8.6%, primarily where we can locate and ligate a definite bleeding point [ 4 ].…”