Idiopathic Spontaneous Intraperitoneal Hemorrhage: A Case Report

Abstract

Idiopathic Spontaneous Intraperitoneal Hemorrhage (ISIH) is a rare and often life threatening condition, traditionally referred as abdominal apoplexy. A 32-year-old man with diffuse abdominal pain, nausea, vomiting, weakness and loss of appetite was referred to the hospital. This man had the history of alcohol consumption. The patient was kept Nil per Os (NPO) and received serum therapy. Six hours after the admission, his abdominal pain gradually increased and he developed hypotension, tachycardia and dizziness. Abdominal ultrasonography was immediately performed which showed intraperitoneal fluid. No evidence of spleen, liver or other internal organ abnormality was seen. The presence of blood was confirmed in abdominal cavity using ultrasound guided puncture. The patient was immediately transferred to operating room. Exploratory laparotomy was carried out and hemoperitoneum was coni¬rmed. Examination of the spleen, liver, bowel, kidneys and mesentery revealed no source of bleeding or existence of subcapsular hematoma. The patient made a fast recovery in the intensive care unit and was discharged in a stable condition after seven days. He was closely followed up for six months without any recurrence or complications related to ISH. This case is the first report of ISIH in a patient in Iran.