Lucha P A
US Naval Hospital, Yokosuka, Japan.
J Am Osteopath Assoc. 1996 Jun;96(6):364-5.
Massive hemoperitoneum seen without an obvious precipitating event is rare. A 21-year-old man was seen with diffuse abdominal pain of 48 hours' duration. He had no fever, nausea, or vomiting, and most laboratory values were normal. Exploration of the abdomen revealed free intraperitoneal blood with clotting but failed to reveal a source. The patient could recall no trauma or other inciting event. The only abnormalities found during laparotomy were multiple adhesions of the omentum to the lateral abdominal wall and localization of most of the clot within the greater omentum. The author cautions that a high index of suspicion followed by laparotomy are the management tools for controlling spontaneous hemoperitoneum. Conservative management produces a high mortality rate.
无明显诱发事件而出现的大量腹腔积血较为罕见。一名21岁男性因持续48小时的弥漫性腹痛前来就诊。他没有发热、恶心或呕吐症状，大多数实验室检查结果正常。腹部探查发现腹腔内有游离血液且已凝血，但未找到出血源。患者回忆不起有任何外伤或其他诱发事件。剖腹手术中发现的唯一异常是大网膜与侧腹壁多处粘连，且大部分血凝块位于大网膜内。作者提醒，高度怀疑后进行剖腹手术是控制自发性腹腔积血的治疗手段。保守治疗会导致高死亡率。
