Vaginal bleeding from massive hemoperitoneum. A case report.
BACKGROUND
A gynecology service is often asked to consult and evaluate in-house patients with vaginal bleeding.


METHODS
A 31-year-old, Asian woman with a history of end-stage renal disease and hemodialysis was admitted to the hospital with a falling hematocrit. She subsequently began to have heavy vaginal bleeding. Computed tomography suggested a peritoneal-cervical fistula. Subsequent exploratory laparotomy documented that the bleeding was caused by retrograde flow of a hemoperitoneum.


CONCLUSIONS
This appears to be the first reported case of retrograde flow from a hemoperitoneum causing vaginal bleeding. Although unusual, this case expands the differential diagnosis when evaluating vaginal bleeding.
Marcus
P
P
Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, USA.
Raff
G
G
Rothenberg
J
J
D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006465:Hemoperitoneum / Q000150:complications* / Q000175:diagnosis*; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D012720:Severity of Illness Index; D014621:Vagina