title: Massive intra-abdominal bleeding caused by nontraumatic rupture of a vein in the colorenal ligament: report of a case.
abstract: We report a case of acute abdomen caused by nontraumatic intra-abdominal bleeding in a 38-year-old man. Emergency laparotomy revealed the source of bleeding as a vein in the right colorenal ligament. The rupture of this vein may have been attributable to shear stress after severe vomiting on the day before admission. Although the patient had a coagulation disorder secondary to early-stage liver cirrhosis, there were no signs of portal hypertension intraoperatively. This report describes an unusual cause of acute hemoperitoneum, highlighting the importance of including this life-threatening disorder in the differential diagnosis of acute abdomen of unknown origin. Its outcome is dependent on early diagnosis and prompt emergency intervention.
authors.affiliation: Department of General Surgery, Technische Universität München, Ismaningerstrasse 22, 81675, Munich, Germany.
authors.forename: Sonja
authors.initials: S
authors.lastname: Gillen
authors.forename: Frank
authors.initials: F
authors.lastname: Martetschläger
authors.forename: Helmut
authors.initials: H
authors.lastname: Friess
authors.forename: Jörg
authors.initials: J
authors.lastname: Kleeff
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D006465:Hemoperitoneum / Q000175:diagnosis / Q000209:etiology*; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D007813:Laparotomy / Q000379:methods*; D008022:Ligaments / Q000098:blood supply*; D008297:Male; D011169:Portal Vein; D012422:Rupture, Spontaneous / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014652:Vascular Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery