McComb Katie, Barghash Mohammed, Eltayef Saleh
General Surgery, North Manchester General Hospital, Manchester, GBR.
General and Colorectal Surgery, North Manchester General Hospital, Manchester, GBR.
Cureus. 2023 Sep 8;15(9):e44879. doi: 10.7759/cureus.44879. eCollection 2023 Sep.
Idiopathic spontaneous intraperitoneal haemorrhage (ISIH) is a rare cause of acute abdominal pain. It refers to haemoperitoneum resulting from the rupture of an intra-abdominal vessel without the preceding trauma or underlying pathology. Here, we present the case of a 17-year-old boy with acute abdominal pain. Initially, acute appendicitis was the primary differential diagnosis. Imaging demonstrated a significant volume of intra-abdominal fluid that was haemorrhagic in nature, but no active bleeding or source was identified. A conservative management approach was adopted due to the patient's clinical improvement during his admission. This case highlights the high index of clinical suspicion required to diagnose and investigate ISIH. In contrast to the historical opinion that stipulates management with a surgical intervention, this case demonstrates the possibility of conservative management in stable patients.
特发性自发性腹腔内出血（ISIH）是急性腹痛的罕见原因。它指的是腹腔内血管破裂导致的腹腔积血，且无先前的创伤或潜在病理状况。在此，我们报告一例17岁急性腹痛男孩的病例。最初，急性阑尾炎是主要的鉴别诊断。影像学检查显示腹腔内有大量血性液体，但未发现活动性出血或出血源。由于患者入院期间临床症状改善，故采取了保守治疗方法。该病例凸显了诊断和研究ISIH所需的高度临床怀疑指数。与规定采用手术干预进行治疗的既往观点不同，本病例表明稳定患者采用保守治疗的可能性。
