Massive hemoperitoneum due to rupture of a retroperitoneal varix.
Intra-abdominal hemorrhage from ruptured varices is an unusual, life-threatening complication of portal hypertension. We present the case of a 58-year-old man with alcoholic cirrhosis who presented with increasing abdominal girth, hypovolemic shock, and profound anemia due to rupture of a retroperitoneal varix into the peritoneal cavity. The clinical presentation of this rare problem is remarkably consistent among published reports. Early recognition may help the treating physician reduce the likelihood of a catastrophic outcome.
Kosowsky
J M
JM
Department of Emergency Medicine and Center for Emergency Care, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Gibler
W B
WB
D000740:Anemia / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D001416:Back Pain / Q000209:etiology; D001803:Blood Transfusion; D004417:Dyspnea / Q000209:etiology; D004638:Emergency Treatment / Q000379:methods; D017809:Fatal Outcome; D006465:Hemoperitoneum / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications*; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D019152:Paracentesis; D012187:Retroperitoneal Space; D012422:Rupture, Spontaneous; D012769:Shock / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014648:Varicose Veins / Q000150:complications* / Q000175:diagnosis / Q000601:surgery