Hemoperitoneum

WikiDoc Resources for Hemoperitoneum
Articles
Most recent articles on Hemoperitoneum Most cited articles on Hemoperitoneum Review articles on Hemoperitoneum Articles on Hemoperitoneum in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Hemoperitoneum Images of Hemoperitoneum Photos of Hemoperitoneum Podcasts & MP3s on Hemoperitoneum Videos on Hemoperitoneum
Evidence Based Medicine
Cochrane Collaboration on Hemoperitoneum Bandolier on Hemoperitoneum TRIP on Hemoperitoneum
Clinical Trials
Ongoing Trials on Hemoperitoneum at Clinical Trials.gov Trial results on Hemoperitoneum Clinical Trials on Hemoperitoneum at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Hemoperitoneum NICE Guidance on Hemoperitoneum NHS PRODIGY Guidance FDA on Hemoperitoneum CDC on Hemoperitoneum
Books
Books on Hemoperitoneum
News
Hemoperitoneum in the news Be alerted to news on Hemoperitoneum News trends on Hemoperitoneum
Commentary
Blogs on Hemoperitoneum
Definitions
Definitions of Hemoperitoneum
Patient Resources / Community
Patient resources on Hemoperitoneum Discussion groups on Hemoperitoneum Patient Handouts on Hemoperitoneum Directions to Hospitals Treating Hemoperitoneum Risk calculators and risk factors for Hemoperitoneum
Healthcare Provider Resources
Symptoms of Hemoperitoneum Causes & Risk Factors for Hemoperitoneum Diagnostic studies for Hemoperitoneum Treatment of Hemoperitoneum
Continuing Medical Education (CME)
CME Programs on Hemoperitoneum
International
Hemoperitoneum en Espanol Hemoperitoneum en Francais
Business
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Experimental / Informatics
List of terms related to Hemoperitoneum

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sunita Kumawat, M.B.B.S[2]

Synonyms and Keywords: peritonel hemorrhage, Hemorrhage into peritoneal cavity, Intraperitoneal hemorrhage, Intraabdominal hemorrhage, abdominal apoplexy, blood in the belly.

Historical Perspective

[Disease name] was first discovered by [name of scientist], a [nationality + occupation], in [year]/during/following [event].

The association between [important risk factor/cause] and [disease name] was made in/during [year/event].

In [year], [scientist] was the first to discover the association between [risk factor] and the development of [disease name].

In [year], [gene] mutations were first implicated in the pathogenesis of [disease name].

There have been several outbreaks of [disease name], including -----.

In [year], [diagnostic test/therapy] was developed by [scientist] to treat/diagnose [disease name].

Classification

Type of hemoperitoneum	Description
Traumatic hemoperitoneum	This is most commonly caused by trauma. This condition occurs when there is bleeding in the peritoneum due to an accident or injury.
Nontraumatic hemoperitoneum	This is also called spontaneous hemoperitoneum. This occurs due to an underlying medical condition.
Iatrogenic hemoperitoneum	This is caused by some medicines or as a complication of procedures or surgery.

There are three types of hemoperitoneum.

‌Traumatic hemoperitoneum. This condition is what happens when an injury or accident causes bleeding into your peritoneum. It is the most common cause of hemoperitoneum.

Nontraumatic hemoperitoneum. This type is what happens when other health conditions cause bleeding in your abdomen. This is sometimes called spontaneous hemoperitoneum. ‌

Iatrogenic hemoperitoneum. This type is a complication of surgery or procedures and some medications that cause bleeding into your abdomen.

There is no established system for the classification of [disease name].

OR

[Disease name] may be classified according to [classification method] into [number] subtypes/groups: [group1], [group2], [group3], and [group4].

OR

[Disease name] may be classified into [large number > 6] subtypes based on [classification method 1], [classification method 2], and [classification method 3]. [Disease name] may be classified into several subtypes based on [classification method 1], [classification method 2], and [classification method 3].

OR

Based on the duration of symptoms, [disease name] may be classified as either acute or chronic.

OR

If the staging system involves specific and characteristic findings and features: According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].

OR

The staging of [malignancy name] is based on the [staging system].

OR

There is no established system for the staging of [malignancy name].

Pathophysiology

The exact pathogenesis of [disease name] is not fully understood.

OR

It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].

OR

[Pathogen name] is usually transmitted via the [transmission route] route to the human host.

OR

Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.

OR

[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].

OR

The progression to [disease name] usually involves the [molecular pathway].

OR

The pathophysiology of [disease/malignancy] depends on the histological subtype.

Causes

Injury to intraabdominal organ or vessel with any of the underlying conditions:

• Blunt abdominal trauma, which results in rupture of liver, kidney, spleen or mesenteric vessels. Sometimes displaced pelvic fractures can lacerate the pelvic or iliac arteries, causing hemoperitoneum.
• Highly vascular intraabdominal tumors can lead to spontaneous bleeding or by invasion of blood vessels.
• Iatrogenic bleeding during abdominal surgery (particularly intestinal anastomosis and resection or enterotomy ) or intraabdominal organ biopsy (kidney, spleen or liver).
• Parturition or late-term pregnancy can cause uterine or ovarian artery rupture.
• Aortic or other vascular rupture, which is rare.
• Coagulopathy can cause spontaneous hemoabdomen on rare occasions.
• Umbilical vessel rupture inside the abdomen in neonates.

○

Disease name] may be caused by [cause1], [cause2], or [cause3].

OR

Common causes of [disease] include [cause1], [cause2], and [cause3].

OR

The most common cause of [disease name] is [cause 1]. Less common causes of [disease name] include [cause 2], [cause 3], and [cause 4].

OR

The cause of [disease name] has not been identified. To review risk factors for the development of [disease name], click here.

Differentiating ((Page name)) from other Diseases

[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].

OR

[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].

Epidemiology and Demographics

The incidence/prevalence of [disease name] is approximately [number range] per 100,000 individuals worldwide.

OR

In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.

OR

In [year], the incidence of [disease name] is approximately [number range] per 100,000 individuals with a case-fatality rate of [number range]%.

Patients of all age groups may develop [disease name].

OR

The incidence of [disease name] increases with age; the median age at diagnosis is [#] years.

OR

[Disease name] commonly affects individuals younger than/older than [number of years] years of age.

OR

[Chronic disease name] is usually first diagnosed among [age group].

OR

[Acute disease name] commonly affects [age group].

There is no racial predilection to [disease name].

OR

[Disease name] usually affects individuals of the [race 1] race. [Race 2] individuals are less likely to develop [disease name].

[Disease name] affects men and women equally.

OR

[Gender 1] are more commonly affected by [disease name] than [gender 2]. The [gender 1] to [gender 2] ratio is approximately [number > 1] to 1.

The majority of [disease name] cases are reported in [geographical region].

OR

[Disease name] is a common/rare disease that tends to affect [patient population 1] and [patient population 2].

Risk Factors

There are no established risk factors for [disease name].

OR

The most potent risk factor in the development of [disease name] is [risk factor 1]. Other risk factors include [risk factor 2], [risk factor 3], and [risk factor 4].

OR

Common risk factors in the development of [disease name] include [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].

OR

Common risk factors in the development of [disease name] may be occupational, environmental, genetic, and viral.

Screening

There is insufficient evidence to recommend routine screening for [disease/malignancy].

OR

According to the [guideline name], screening for [disease name] is not recommended.

OR

According to the [guideline name], screening for [disease name] by [test 1] is recommended every [duration] among patients with [condition 1], [condition 2], and [condition 3].

Natural History, Complications, and Prognosis

Complications

When not treated promptly, serious complications can arise if you have hemoperitoneum. The peritoneal cavity is unique because it can hold almost all the circulating blood volume of the average person. It’s possible for blood to accumulate in the cavity extremely quickly. This can cause you to go into shock from blood loss, become unresponsive, and even result in death.

If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].

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Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].

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Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.

Diagnosis

Diagnostic Study of Choice

The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].

OR

The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].

OR

The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].

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There are no established criteria for the diagnosis of [disease name].

History and Symptoms

The symptoms of internal bleeding can be hard to catch unless there is a blunt trauma or accident that prompts a visit to the hospital. One study showed that even vital signs, like heart rate and blood pressure, can vary greatly from case to case.

Symptoms of internal bleeding in the pelvic or abdominal area can escalate and become the symptoms of shock. Some symptoms of hemoperitoneum include:

• tenderness at the site of your abdomen
• sharp or stabbing pain in your pelvic area
• dizziness or confusion
• nausea or vomiting
• cold, clammy skin

The majority of patients with [disease name] are asymptomatic.

OR

The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. Common symptoms of [disease] include [symptom 1], [symptom 2], and [symptom 3]. Less common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].

Physical Examination

Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].

OR

Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].

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The presence of [finding(s)] on physical examination is diagnostic of [disease name].

OR

The presence of [finding(s)] on physical examination is highly suggestive of [disease name].

Laboratory Findings

• Serum labs    
  • complete blood count
    • assess for need for transfusion
  • blood type and cross
• Invasive studies
  • diagnostic peritoneal lavage (abdominal paracentesis)
    • indication
      • can rapidly determine presence of intraperitoneal blood
      • hemodynamically unstable patient in whom FAST exam may not be useful (i.e., obstructed views)

An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].

OR

Laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

OR

[Test] is usually normal among patients with [disease name].

OR

Some patients with [disease name] may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].

OR

There are no diagnostic laboratory findings associated with [disease name].

Electrocardiogram

There are no ECG findings associated with [disease name].

OR

An ECG may be helpful in the diagnosis of [disease name]. Findings on an ECG suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

X-ray

There are no x-ray findings associated with [disease name].

OR

An x-ray may be helpful in the diagnosis of [disease name]. Findings on an x-ray suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no x-ray findings associated with [disease name]. However, an x-ray may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

Echocardiography or Ultrasound

There are no echocardiography/ultrasound findings associated with [disease name].

OR

Echocardiography/ultrasound may be helpful in the diagnosis of [disease name]. Findings on an echocardiography/ultrasound suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no echocardiography/ultrasound findings associated with [disease name]. However, an echocardiography/ultrasound may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

CT scan

• Focused assessment with sonography for trauma (FAST)
  • indication
    • rapid diagnosis of hemoperitoneum
    • may not determine source of hemorrhage
  • findings
    • blood in peritoneal cavity
• Computed tomography
  • indications
    • detection of solid organ injury
    • can determine source of hemorrhage
    • hemodynamically stable patients
  • findings
    • solid organ injury

There are no CT scan findings associated with [disease name].

OR

[Location] CT scan may be helpful in the diagnosis of [disease name]. Findings on CT scan suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no CT scan findings associated with [disease name]. However, a CT scan may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

MRI

There are no MRI findings associated with [disease name].

OR

[Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no MRI findings associated with [disease name]. However, a MRI may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

Other Imaging Findings

There are no other imaging findings associated with [disease name].

OR

[Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

Other Diagnostic Studies

There are no other diagnostic studies associated with [disease name].

OR

[Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

Other diagnostic studies for [disease name] include [diagnostic study 1], which demonstrates [finding 1], [finding 2], and [finding 3], and [diagnostic study 2], which demonstrates [finding 1], [finding 2], and [finding 3].

Treatment

Medical Therapy

There is no treatment for [disease name]; the mainstay of therapy is supportive care.

OR

Supportive therapy for [disease name] includes [therapy 1], [therapy 2], and [therapy 3].

OR

The majority of cases of [disease name] are self-limited and require only supportive care.

OR

[Disease name] is a medical emergency and requires prompt treatment.

OR

The mainstay of treatment for [disease name] is [therapy].

OR   The optimal therapy for [malignancy name] depends on the stage at diagnosis.

OR

[Therapy] is recommended among all patients who develop [disease name].

OR

Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].

OR

Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].

OR

Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].

OR

Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].

Surgery

Surgical intervention is not recommended for the management of [disease name].

OR

Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]

OR

The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].

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The feasibility of surgery depends on the stage of [malignancy] at diagnosis.

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Surgery is the mainstay of treatment for [disease or malignancy].

Primary Prevention

There are no established measures for the primary prevention of [disease name].

OR

There are no available vaccines against [disease name].

OR

Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].

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[Vaccine name] vaccine is recommended for [patient population] to prevent [disease name]. Other primary prevention strategies include [strategy 1], [strategy 2], and [strategy 3].

Secondary Prevention

There are no established measures for the secondary prevention of [disease name].

OR

Effective measures for the secondary prevention of [disease name] include [strategy 1], [strategy 2], and [strategy 3].