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Idiopathic Spontaneous Hemoperitoneum

Ami Schattner, MD; Natasha Kozack, MD; Joshua Friedman, MD
Arch Intern Med. 2001;161(7):1009-1010. doi:.
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A diagnosis of occult intra-abdominal bleeding is usually considered in patients with a predisposing condition. Hemoperitoneum will be readily considered in the differential diagnosis of patients who have been injured, who are treated with anticoagulants, who have a known abdominal tumor when they exhibit the signs and symptoms of hypovolemia, or who have a falling hematocrit. However, idiopathic occurrence of hemoperitoneum is rare, and therefore poorly recognized, which may cause a dangerous diagnostic delay.

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Abdominal computed tomographic scan showing large intra-abdominal bleeding (25 Hounsfield units; arrow) from the level of the diaphragm to the level of the small pelvis. No other pathologic condition of abdominal or pelvic organs was found.

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