title: Massive spontaneous intraperitoneal hemorrhage in a young female with chronic immune thrombocytopenic purpura masquerading as ruptured ovarian cyst: successful nonsurgical management of this rare catastrophic event.
abstract: Chronic immune thrombocytopenic purpura has mild bleeding manifestations and severe bleeding requiring hospitalization is rare. We are reporting a case of a 19-year-old girl with chronic immune thrombocytopenic purpura who presented with spontaneous massive hemoperitoneum without any identifiable source of hemorrhage. We chose nonsurgical treatment over laparotomy, and the patient was managed successfully with parenteral steroids and platelet transfusion. In young women presenting with massive hemoperitoneum, undiagnosed immune thrombocytopenia should be considered as an etiology. In absence of any identifiable source of hemoperitoneum, these patients may not require laparotomy and treatment with intravenous corticosteroid and platelet transfusions may be preferrable and lifesaving.
authors.affiliation: From the Department of Obstetrics and Gynaecology, Maulana Azad Medical College, New Delhi, India.
authors.forename: Nilanchali
authors.initials: N
authors.lastname: Singh
authors.forename: Reva
authors.initials: R
authors.lastname: Tripathi
authors.forename: Y M
authors.initials: YM
authors.lastname: Mala
authors.forename: Shakun
authors.initials: S
authors.lastname: Tyagi
authors.forename: Namita
authors.initials: N
authors.lastname: Jain
mesh_terms: D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D006465:Hemoperitoneum / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007813:Laparotomy; D010048:Ovarian Cysts / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications* / Q000175:diagnosis; D012422:Rupture, Spontaneous; D055815:Young Adult