Conservative management of a rare case of idiopathic spontaneous intraperitoneal haemorrhage: A case report

Idiopathic spontaneous intraperitoneal haemorrhage, previously known as abdominal apoplexy, refers to bleeding into the peritoneal cavity due to the non-traumatic rupture of a visceral artery. It is a rare clinical condition that requires prompt diagnosis and management. The aetiology remains unclea...

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Main Authors: Tirumalai Ramaswamy Anagha, Noor Ul Hassan
Format: Article
Language:English
Published: SAGE Publishing 2025-06-01
Series:SAGE Open Medical Case Reports
Online Access:https://doi.org/10.1177/2050313X251345933
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author Tirumalai Ramaswamy Anagha
Noor Ul Hassan
author_facet Tirumalai Ramaswamy Anagha
Noor Ul Hassan
author_sort Tirumalai Ramaswamy Anagha
collection DOAJ
description Idiopathic spontaneous intraperitoneal haemorrhage, previously known as abdominal apoplexy, refers to bleeding into the peritoneal cavity due to the non-traumatic rupture of a visceral artery. It is a rare clinical condition that requires prompt diagnosis and management. The aetiology remains unclear, though factors such as atherosclerosis, coagulopathies, pancreatitis, malignancy and hypertension are often implicated. Very few cases have been reported where no clear aetiological cause could be identified. Here, we present the case of a 52-year-old man who was diagnosed with idiopathic spontaneous intraperitoneal haemorrhage and successfully managed conservatively. The diagnosis was confirmed through contrast-enhanced computed tomography and magnetic resonance imaging, which revealed a spontaneous mesenteric haematoma located in the right lumbar region with mild haemoperitoneum. The patient was managed with blood transfusion, IV fluids, and close monitoring; eventually, the haematoma showed signs of resolution and patient was discharged on day 10 and followed up on an outpatient basis till the haematoma completely resolved. This case report emphasis the need to maintain a high index of suspicion for spontaneous mesenteric haematoma in patients presenting with unexplained abdominal pain and haemodynamic instability, even in the absence of trauma as well as how unnecessary surgery can be avoided to reduce morbidity and improve recovery in carefully selected cases.
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spelling doaj-art-3e64aa374e244e24a98de7d7dd3321802025-08-20T02:10:09ZengSAGE PublishingSAGE Open Medical Case Reports2050-313X2025-06-011310.1177/2050313X251345933Conservative management of a rare case of idiopathic spontaneous intraperitoneal haemorrhage: A case reportTirumalai Ramaswamy Anagha0Noor Ul Hassan1Department of General Surgery, Bangalore Medical College and Research Institute, Bengaluru, IndiaDepartment of General Surgery, Bangalore Medical College and Research Institute, Bengaluru, IndiaIdiopathic spontaneous intraperitoneal haemorrhage, previously known as abdominal apoplexy, refers to bleeding into the peritoneal cavity due to the non-traumatic rupture of a visceral artery. It is a rare clinical condition that requires prompt diagnosis and management. The aetiology remains unclear, though factors such as atherosclerosis, coagulopathies, pancreatitis, malignancy and hypertension are often implicated. Very few cases have been reported where no clear aetiological cause could be identified. Here, we present the case of a 52-year-old man who was diagnosed with idiopathic spontaneous intraperitoneal haemorrhage and successfully managed conservatively. The diagnosis was confirmed through contrast-enhanced computed tomography and magnetic resonance imaging, which revealed a spontaneous mesenteric haematoma located in the right lumbar region with mild haemoperitoneum. The patient was managed with blood transfusion, IV fluids, and close monitoring; eventually, the haematoma showed signs of resolution and patient was discharged on day 10 and followed up on an outpatient basis till the haematoma completely resolved. This case report emphasis the need to maintain a high index of suspicion for spontaneous mesenteric haematoma in patients presenting with unexplained abdominal pain and haemodynamic instability, even in the absence of trauma as well as how unnecessary surgery can be avoided to reduce morbidity and improve recovery in carefully selected cases.https://doi.org/10.1177/2050313X251345933
spellingShingle Tirumalai Ramaswamy Anagha
Noor Ul Hassan
Conservative management of a rare case of idiopathic spontaneous intraperitoneal haemorrhage: A case report
SAGE Open Medical Case Reports
title Conservative management of a rare case of idiopathic spontaneous intraperitoneal haemorrhage: A case report
title_full Conservative management of a rare case of idiopathic spontaneous intraperitoneal haemorrhage: A case report
title_fullStr Conservative management of a rare case of idiopathic spontaneous intraperitoneal haemorrhage: A case report
title_full_unstemmed Conservative management of a rare case of idiopathic spontaneous intraperitoneal haemorrhage: A case report
title_short Conservative management of a rare case of idiopathic spontaneous intraperitoneal haemorrhage: A case report
title_sort conservative management of a rare case of idiopathic spontaneous intraperitoneal haemorrhage a case report
url https://doi.org/10.1177/2050313X251345933
work_keys_str_mv AT tirumalairamaswamyanagha conservativemanagementofararecaseofidiopathicspontaneousintraperitonealhaemorrhageacasereport
AT noorulhassan conservativemanagementofararecaseofidiopathicspontaneousintraperitonealhaemorrhageacasereport