title: Spontaneous haemoperitoneum due to a sigmoid diverticulum.
abstract: Spontaneous haemoperitoneum is rare. When it occurs it is a life-threatening condition. Common causes of this are gynaecological in nature and rarely due to colonic diverticular perforation. Diverticulitis is a common condition affecting people in western countries. This presentation of spontaneous haemoperitoneum highlights the disproportionate abdominal pain and opioid-induced constipation. Significant bloods on admission included haemoglobin of 148 g/L, C reactive protein (CRP) of 1.1 mg/L, white cell count (WCC) of 12.7×10(9)/L (neutrophils 10.9×10(9)/L). Bloods repeated 10 h later revealed the haemoglobin had dropped to 100 g/L, CRP had increased significantly to 120 mg/L, WCC: 7.4×10(9)/L (neutrophils 5.3×10(9)/L) and a reduced packed cell volume: 0.307 L/L. CT scan revealed free fluid and a possible mass. At laparoscopy, frank haemoperitoneum was seen and a decision was made to open and perform a Hartmann's procedure. The patient did very well postoperatively and was discharged on the ninth postoperative day. He is currently awaiting reversal of the ileostomy.
authors.affiliation: Respiratory Department, Abertawe Bro Morgannwg University Health Board, Swansea, UK.
authors.forename: Jayan
authors.initials: J
authors.lastname: George
authors.affiliation: Department of General Surgical Directorate, Wrexham Maelor Hospital, Wrexham, UK.
authors.forename: Abozed
authors.initials: A
authors.lastname: Ben-Sassi
authors.affiliation: Department of Radiology, Wrexham Maelor Hospital, Wrexham, UK.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Dixon
mesh_terms: D000006:Abdomen, Acute / Q000175:diagnosis / Q000209:etiology; D000328:Adult; D012809:Colon, Sigmoid / Q000000981:diagnostic imaging / Q000601:surgery*; D004241:Diverticulum, Colon / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D004636:Emergency Service, Hospital; D004638:Emergency Treatment; D005500:Follow-Up Studies; D006465:Hemoperitoneum / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D007416:Intestinal Perforation / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D007813:Laparotomy / Q000379:methods; D008297:Male; D035583:Rare Diseases; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome