Lovitskyi Yurii, Romanenko Yaryna, Shcherbyna Maksym, Zadorozhna Kristina, Kalyna Roman, Herasymenko Evhen, Kopchak Kostiantyn
Department of Surgery, Medical Network "Dobrobut", Idzikovskih, 3, Kyiv 2100, Ukraine.
J Surg Case Rep. 2024 Aug 3;2024(8):rjae475. doi: 10.1093/jscr/rjae475. eCollection 2024 Aug.
Introduction and importance: Spontaneous hemoperitoneum (SH) is a rare, life-threatening condition characterized by nontraumatic and non-iatrogenic intraperitoneal bleeding. This article explores three unique cases of SH, shedding light on unusual causes and emphasizing the critical role of diagnostic imaging and exploratory laparotomy in management.
The study was a retrospective single-center non-consecutive case series.
We report three distinct cases of SH, each originating from uncommon sources: rupture of greater omentum arterio-venous malformation, a branch of the left gastric artery, and pathological splenic rupture. Clinical evaluation, diagnostic imaging, and surgical interventions are detailed for each case.
These rare cases underscore the diverse etiologies of SH, including idiopathic omental bleeding, gastric intramural hematoma, and atraumatic splenic rupture. Enhanced CT imaging plays a crucial role in diagnosis, enabling the characterization of underlying pathologies. Exploratory laparotomy proves to be an essential treatment option for unstable patients with suspected or confirmed diagnoses of SH.
引言与重要性：自发性血腹（SH）是一种罕见的、危及生命的病症，其特征为非创伤性和非医源性腹腔内出血。本文探讨了三例独特的SH病例，揭示了不寻常的病因，并强调了诊断性影像学检查和剖腹探查术在治疗中的关键作用。
本研究为回顾性单中心非连续病例系列。
我们报告了三例不同的SH病例，每例均源于不常见的病因：大网膜动静脉畸形破裂、胃左动脉分支破裂以及病理性脾破裂。详细介绍了每例病例的临床评估、诊断性影像学检查和手术干预情况。
这些罕见病例强调了SH的多种病因，包括特发性网膜出血、胃壁内血肿和非创伤性脾破裂。增强CT成像在诊断中起着关键作用，能够明确潜在病变的特征。对于疑似或确诊为SH的不稳定患者，剖腹探查术被证明是一种重要的治疗选择。
