Idiopathic Spontaneous Intraperitoneal Hemorrhage: A Case Report

Spontaneous hemoperitoneum is described as the presence of blood in the peritoneal cavity that is not associated with traumas. The phenomenon can be idiopathic or related to spontaneous rupture of either known or unknown pathology [1]. The cause of nontraumatic spontaneous hemoperitoneum can be classified as vascular, hematological, hepatic, splenic, gynecological, and inflammatory or coagulation disorder or cryptogenic disease [2]. Idiopathic Spontaneous Intraperitoneal Hemorrhage (ISIH) is a rare and often life threatening condition, also traditionally known as abdominal apoplexy [3]. The majority of cases are diagnosed postoperatively. Even after a comprehensive abdominal exploration, the origin of hemorrhage often remains unclear [2,4]. However ISIH is not common and occurs rarely, it represents a real emergency condition and must be considered in any patient with atypical abdominal pain and hemodynamic instability [5,6]. Nonspecific symptoms usually include abdominal pain, abdominal distension, nausea, vomiting and hemodynamic instability [6]. To the authors’ best knowledge, this case is the first report of ISIH in Iran.