简介和重要性:自发性腹膜积血(SH)是一种罕见的,以非创伤性和非医源性腹膜内出血为特征的危及生命的状况。本文探讨了SH的三个独特案例,阐明异常原因,并强调诊断成像和剖腹探查术在治疗中的关键作用。
方法:本研究为回顾性单中心非连续病例系列。
结果:我们报告了三例不同的SH,每个都源于罕见的来源:大网膜动静脉畸形破裂,胃左动脉的一个分支,和病理性脾破裂。临床评价,诊断成像,每个病例都有详细的手术干预措施。
结论: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成像在诊断中起着至关重要的作用,能够表征潜在的病理。对于怀疑或确诊为SH的不稳定患者,剖腹探查术被证明是必不可少的治疗选择。
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.
METHODS: The study was a retrospective single-center non-consecutive case series.
RESULTS: 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.
CONCLUSIONS: 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.