Spontaneous Hemoperitoneum Because of a Ruptured GIST without Abdominal Pain

We experienced a rare case of spontaneous hemoperitoneum because of a ruptured malignant gastrointestinal stromal tumor (GIST), with only abdominal bloating and no abdominal pain. GIST is a common mesenchymal tumor of the gastrointestinal tract. Because of the high vascularity of the tumor, GISTs are frequently associated with gastrointestinal bleeding. Most patients present with abdominal pain at the onset of rupture, and the absence of abdominal pain complicated the management of this patient. To confirm or exclude a diagnosis of hemoperitoneum combined with a gastric submucosal tumor and intra-abdominal fluid, careful observation is required.