Massive spontaneous hemoperitoneum due to rupture of visceral branches of the abdominal aorta.
Review of 153 cases of massive spontaneous hemoperitoneum following visceral arterial rupture showed that 94% of all young women and 100% of all pregnant women had ruptured congenital splenic artery aneurysms at the time of hemorrhage, whereas young males bled from a variety of sources. Individuals who were 45 years old or older bled either from lesions of the celiac axis or its branches (66%) or from arterial mesenteric system lesions (34%). Only 22% of the older individuals of either sex bled from splenic artery sources. Arterial hypertension was present in 40% and previous or simultaneous intracranial hemorrhage occurred in 9% of the older patients. There were no survivors among those in whom the bleeding source was not operatively controlled. With operation, 79% of the younger patients and 57% of the older ones survived. Results emphasize the high mortality of visceral artery rupture with intraperitoneal bleeding. Prophylactic excision is advised for all complicated aneurysms regardless of age and all uncomplicated aneurysms in healthy individuals, especially in fertile or pregnent women.
D000328:Adult; D000367:Age Factors; D000783:Aneurysm / Q000150:complications / Q000601:surgery; D002445:Celiac Artery / Q000601:surgery*; D002543:Cerebral Hemorrhage / Q000150:complications; D005260:Female; D006465:Hemoperitoneum / Q000209:etiology* / Q000401:mortality; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008638:Mesenteric Arteries / Q000601:surgery*; D008875:Middle Aged; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D012422:Rupture, Spontaneous; D013157:Splenic Artery / Q000601:surgery*; D014652:Vascular Diseases / Q000601:surgery