hemoperitoneum

Hemoperitoneum • Ruptured corpus luteum cyst - Ganzer Fall bei Radiopaedia

Hemoperitoneum

• Ruptured corpus luteum cyst - Ganzer Fall bei Radiopaedia

Shah, V. Ruptured corpus luteum cyst. Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-54789 • CC by-nc-sa 3.0 (modified)

Stumpfes Bauchtrauma mit mesokolischer Einblutung rechts: Links oben hyperdenser Flüssigkeitssaum um die Leber und um die Milz, links Mitte fokale und diffuse Einblutung im rechten Mesocolon, links unten sagittal und rechts oben coronar beide Befunde. Rechts unten intraoperativer Situs mit großem Hämatom im Mesocolon.

Stumpfes

Bauchtrauma mit mesokolischer Einblutung rechts: Links oben hyperdenser Flüssigkeitssaum um die Leber und um die Milz, links Mitte fokale und diffuse Einblutung im rechten Mesocolon, links unten sagittal und rechts oben coronar beide Befunde. Rechts unten intraoperativer Situs mit großem Hämatom im Mesocolon.

Wikipedia • CC BY-SA 4.0

School ager gymnast who fell onto a balance beam. Axial CT with contrast of the abdomen (above) shows a low-density laceration in the center of the spleen with a round focus of high intensity in the middle of it felt to represent active bleeding. Axial CT with contrast of the pelvis (below) shows a large amount of fluid in the pelvis posterior to the bladder.The diagnosis was splenic trauma with active splenic bleeding and a large amount of hemoperitoneum.

School ager

gymnast who fell onto a balance beam. Axial CT with contrast of the abdomen (above) shows a low-density laceration in the center of the spleen with a round focus of high intensity in the middle of it felt to represent active bleeding. Axial CT with contrast of the pelvis (below) shows a large amount of fluid in the pelvis posterior to the bladder.The diagnosis was splenic trauma with active splenic bleeding and a large amount of hemoperitoneum.

pediatricimaging.org • CC-by-nc-sa 4.0

Imaging for acute pelvic pain in pregnancy. A 27-year-old woman presenting at the emergency department with acute pelvic pain. Abdominal US (a) shows a rounded lesion adjacent to the uterus, clearly separate from the left ovary. Axial CT scan shows a voluminous mass in the pelvic cavity (b); for the characterisation an MRI was required. Axial (c) and coronal (d) T2-weighted and T1-weighted images (e) of the pelvis show a right heterogeneous adnexal mass (arrow) with fallopian tube haematoma. Note the normal ovary (short arrow) in (c). Pre-contrast T1-weighted fat-saturated image (f) shows bloody ascites (short arrows). These findings are due to ectopic pregnancy with tubal rupture and haemoperitoneum

Imaging for

acute pelvic pain in pregnancy. A 27-year-old woman presenting at the emergency department with acute pelvic pain. Abdominal US (a) shows a rounded lesion adjacent to the uterus, clearly separate from the left ovary. Axial CT scan shows a voluminous mass in the pelvic cavity (b); for the characterisation an MRI was required. Axial (c) and coronal (d) T2-weighted and T1-weighted images (e) of the pelvis show a right heterogeneous adnexal mass (arrow) with fallopian tube haematoma. Note the normal ovary (short arrow) in (c). Pre-contrast T1-weighted fat-saturated image (f) shows bloody ascites (short arrows). These findings are due to ectopic pregnancy with tubal rupture and haemoperitoneum

insightsimaging.springeropen.com • Open Access

Ruptured endometrioma in a nonpregnant patient: a case report. Large left pelvic hypodense structure (yellow arrow) drained by left gonadal vein (red arrow). There is moderate-volume ascites (blue arrows)

Ruptured

endometrioma in a nonpregnant patient: a case report. Large left pelvic hypodense structure (yellow arrow) drained by left gonadal vein (red arrow). There is moderate-volume ascites (blue arrows)

jmedicalcasereports.biomedcentral.com • CC-by-4.0

Ruptured endometrioma in a nonpregnant patient: a case report. Hemoperitonieum with layering hyperdense material (blue arrow) compatible with blood products

Ruptured

endometrioma in a nonpregnant patient: a case report. Hemoperitonieum with layering hyperdense material (blue arrow) compatible with blood products

jmedicalcasereports.biomedcentral.com • CC-by-4.0

Ruptured endometrioma in a nonpregnant patient: a case report. Focal rim discontinuity of the dome of the left adnexal cystic mass (red arrow)

Ruptured

endometrioma in a nonpregnant patient: a case report. Focal rim discontinuity of the dome of the left adnexal cystic mass (red arrow)

jmedicalcasereports.biomedcentral.com • CC-by-4.0

Hemoperitoneum • Hemoperitoneum - Ganzer Fall bei Radiopaedia

Hemoperitoneum

• Hemoperitoneum - Ganzer Fall bei Radiopaedia

Radswiki, T. Hemoperitoneum. Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-11474 • CC by-nc-sa 3.0 (modified)

Hemoperitoneum • Acute mesenteric hematoma with active bleeding - Ganzer Fall bei Radiopaedia

Hemoperitoneum

• Acute mesenteric hematoma with active bleeding - Ganzer Fall bei Radiopaedia

St-Amant, M. Acute mesenteric hematoma with active bleeding. Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-20112 • CC by-nc-sa 3.0 (modified)

Hemoperitoneum • Hemoperitoneum post traumatic splenic injury - Ganzer Fall bei Radiopaedia

Hemoperitoneum

• Hemoperitoneum post traumatic splenic injury - Ganzer Fall bei Radiopaedia

Jones, J. Hemoperitoneum post traumatic splenic injury. Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-14361 • CC by-nc-sa 3.0 (modified)

Hemoperitoneum • Ruptured corpus luteum with large hemoperitoneum - Ganzer Fall bei Radiopaedia

Hemoperitoneum

• Ruptured corpus luteum with large hemoperitoneum - Ganzer Fall bei Radiopaedia

Stanislavsky, A. Ruptured corpus luteum with large hemoperitoneum. Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-13489 • CC by-nc-sa 3.0 (modified)

Postoperative bleeding after pancreaticoduodenectomy: CT findings and role. Multiplanar images from preoperative CT showed moderately dilated intrahepatic bile ducts (+), overdistended gallbladder (§), common bile duct dilatation (short arrows) with distal \"tapering\" stricture (arrowheads). Signs of vascular invasion and distant metastases were not seen.

Postoperative

bleeding after pancreaticoduodenectomy: CT findings and role. Multiplanar images from preoperative CT showed moderately dilated intrahepatic bile ducts (+), overdistended gallbladder (§), common bile duct dilatation (short arrows) with distal \"tapering\" stricture (arrowheads). Signs of vascular invasion and distant metastases were not seen.

www.eurorad.org • CC by-nc-sa-4.0

Hemoperitoneum • Hepatocellular carcinoma rupture with hemoperitoneum - Ganzer Fall bei Radiopaedia

Hemoperitoneum

• Hepatocellular carcinoma rupture with hemoperitoneum - Ganzer Fall bei Radiopaedia

Bickle, I. Hepatocellular carcinoma rupture with hemoperitoneum. Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-45568 • CC by-nc-sa 3.0 (modified)

Hemoperitoneum • Ruptured corpus luteum cyst with hemoperitoneum - Ganzer Fall bei Radiopaedia

Hemoperitoneum

• Ruptured corpus luteum cyst with hemoperitoneum - Ganzer Fall bei Radiopaedia

Gada R, Ruptured corpus luteum cyst with hemoperitoneum. Case study, Radiopaedia.org (Accessed on 01 Jun 2023) https://doi.org/10.53347/rID-156867 • CC by-nc-sa 3.0 (modified)

School ager after motor vehicle accident with abdominal pain. Axial CT with contrast of the abdomen shows the bladder in the center of the image partially filled with contrast and surrounded by a large amount of free fluid throughout the pelvis.The diagnosis was splenic trauma with an extensive amount of hemoperitoneum.

School ager

after motor vehicle accident with abdominal pain. Axial CT with contrast of the abdomen shows the bladder in the center of the image partially filled with contrast and surrounded by a large amount of free fluid throughout the pelvis.The diagnosis was splenic trauma with an extensive amount of hemoperitoneum.

pediatricimaging.org • CC-by-nc-sa 4.0

Sheathed goring: an unusual mechanism of trauma. MDCT revealed the presence of high-attenuated peritoneal fluid in the pelvic cavity (45 HU) due to haemoperitoneum.

Sheathed

goring: an unusual mechanism of trauma. MDCT revealed the presence of high-attenuated peritoneal fluid in the pelvic cavity (45 HU) due to haemoperitoneum.

www.eurorad.org • CC by-nc-sa-4.0

Radiopaedia • CC-by-nc-sa 3.0 • de

siehe auch

Endometriose
peritoneal cavity
eitrige Perikarditis
hämorrhagische Pankreatitis
intraabdominelle Blutungen

Hemoperitoneum (plural: haemoperitoneums) is the presence of blood within the peritoneal cavity.

Pathology

Etiology

penetrating or non-penetrating abdominal trauma (often with associated organ injury)
ruptured ectopic pregnancy
ovarian cyst rupture
aneurysm or pseudoaneurysm rupture
neoplasm rupture
acute hemorrhagic pancreatitis
iatrogenic
spontaneous bleeding, especially patients with coagulopathy or on anticoagulant therapy (uncommon)

Radiographic features

Ultrasound

non-specific appearance of intraperitoneal free fluid
- may be hypo-, iso- or hyperechoic
may demonstrate fluid-fluid levels with mixed internal echogenicity

CT

The density of fluid in the abdomen suggests its composition (i.e. ascites/bowel contents/bile vs hemorrhage) :

recent hemorrhage (acute bleed) measures 30-45 HU
clotted blood measures 45-70 HU
old blood products/seroma or blood in patients with anemia may measure <30 HU

A collection of blood products can be homogeneous or heterogeneous (often low density with internal linear/nodular hyperdensities) ; fluid-fluid levels are often present.

MRI

acute (<48 hours) hemoperitoneum has non-specific signal characteristics
subacute (>3 weeks) may demonstrate concentric ring sign
fluid-fluid levels (hematocrit effect) with high T1 / low T2 signal noted dependently

Differential diagnosis

low-density hemoperitoneum may be indistinguishable from ascites or other causes of peritoneal free fluid
there may be a delayed increase in ascites attenuation after administration of IV contrast (up to 3 days)
- there may be an increase of up to 25 HU