Idiopathic spontaneous intraperitoneal haemorrhage

ABSTRACT

Idiopathic spontaneous intraperitoneal haemorrhage is a rare and potentially fatal condition. Pre-operative diagnosis is difficult or rarely possible. Urgent surgical exploration is the treatment of choice. We report a case of spontaneous intraperitoneal haemorrhage that was observed undergoing sudden deterioration of her condition while in a hospital ward. She was attending to her child admitted in the ward. She developed lower abdominal pain and extreme weakness. Hospital staff recognized her to be gradually undergoing a state of shock. She was resuscitated and urgent ultrasound abdomen revealed free fluid in the abdomen and pelvis. Immediate laparotomy confirmed the diagnosis of spontaneous intraperitoneal bleeding, however, no significant cause of bleeding was found except for a very small area of breached peritoneum in the pouch of Douglas. Haemostasis was secured by two stitches of vicryl. Postoperative CT scan of abdomen and pelvis did not reveal any abnormal finding. Patient was followed-up in the OPD for 6 months and she was symptom-free and in a healthy state