Intra-abdominal bleeding in a 14-year-old girl with acute immune thrombocytopenic purpura.

We describe a 14-year-old girl with acute immune thrombocytopenic purpura. She presented with acute abdominal pain, and her hematocrit decreased from 44% to 29%. The bleeding was due to the rupture of a distended follicle on about the 14th day of her menstrual cycle. The patient's low platelet count made possible the continuous oozing of blood from the follicle into the abdominal cavity, causing peritoneal irritation and the fall in hematocrit. She received treatment with intravenous Ig. This case indicates that unnecessary surgery can be avoided if there is reason to believe that the cause of internal bleeding does not require surgical intervention.