[Spontaneous intraperitoneal hemorrhage in patients with cirrhosis of the liver: a complication of extra-intestinal shunts].
Haemoperitoneum due to a ruptured porta-systemic shunt in patients with cirrhosis and portal hypertension seems to be rare, and the diagnosis is generally first established during surgery. A case of intraperitoneal bleeding due to a ruptured varix in a cluster of varices between the greater omentum and the right broad ligament is reported and the literature is reviewed. In cirrhotic patients, sudden onset of abdominal pain in combination with hypotension should result in ultrasonography of the abdomen. Any free fluid present should be aspirated and when blood is encountered the patient must be operated upon immediately. The mortality rate is high. Suture ligation of the bleeding varix seems to give the greatest likelihood of survival.
Gyrtrup
H J
HJ
Rigshospitalet, kirurgisk afdeling C, København.
Jendresen
M
M
Svendsen
L B
LB
D000328:Adult; D005260:Female; D006465:Hemoperitoneum / Q000209:etiology*; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000601:surgery*; D011170:Portasystemic Shunt, Surgical / Q000009:adverse effects*