title: Abdominal apoplexy: a case report and review.
abstract: Abdominal apoplexy, or the newer term, idiopathic spontaneous intraperitoneal hemorrhage (ISIH), represents a rare cause of non-traumatic intra-abdominal bleeding. As with any acute blood loss, this problem often presents to the Emergency Department (ED) for initial evaluation and resuscitation. The case of a 52-year-old man with abdominal pain and distention due to spontaneous intraperitoneal hemorrhage is presented. This patient developed impending cardiovascular compromise in the ED and was subsequently diagnosed by computed tomography scan as having an intra-abdominal hematoma. Emergent exploratory laparotomy was performed and the patient was found to have spontaneous bleeding from a branch of the middle colic artery that was ligated without complication. The patient recovered well with no recurrent bleeding. The pathophysiology, diagnostic approach, and treatment of ISIH are reviewed.
authors.affiliation: Department of Emergency Medicine, Texas A&M University Health Science Center, College of Medicine, Scott & White Clinic, Temple, Texas 76508, USA.
authors.forename: John C
authors.initials: JC
authors.lastname: Cawyer
authors.forename: C Keith
authors.initials: CK
authors.lastname: Stone
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology*; D000208:Acute Disease; D004636:Emergency Service, Hospital; D004638:Emergency Treatment / Q000379:methods; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging*; D006465:Hemoperitoneum / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D007813:Laparotomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods