RESUMEN

Spontaneous haemoperitoneum is rare. When it occurs it is a life-threatening condition. Common causes of this are gynaecological in nature and rarely due to colonic diverticular perforation. Diverticulitis is a common condition affecting people in western countries. This presentation of spontaneous haemoperitoneum highlights the disproportionate abdominal pain and opioid-induced constipation. Significant bloods on admission included haemoglobin of 148 g/L, C reactive protein (CRP) of 1.1 mg/L, white cell count (WCC) of 12.7×10(9)/L (neutrophils 10.9×10(9)/L). Bloods repeated 10 h later revealed the haemoglobin had dropped to 100 g/L, CRP had increased significantly to 120 mg/L, WCC: 7.4×10(9)/L (neutrophils 5.3×10(9)/L) and a reduced packed cell volume: 0.307 L/L. CT scan revealed free fluid and a possible mass. At laparoscopy, frank haemoperitoneum was seen and a decision was made to open and perform a Hartmann's procedure. The patient did very well postoperatively and was discharged on the ninth postoperative day. He is currently awaiting reversal of the ileostomy.

Asunto(s)

Colon Sigmoide/cirugía , Divertículo del Colon/diagnóstico por imagen , Hemoperitoneo/etiología , Hemoperitoneo/cirugía , Perforación Intestinal/cirugía , Abdomen Agudo/diagnóstico , Abdomen Agudo/etiología , Adulto , Colon Sigmoide/diagnóstico por imagen , Divertículo del Colon/complicaciones , Divertículo del Colon/cirugía , Servicio de Urgencia en Hospital , Tratamiento de Urgencia , Estudios de Seguimiento , Hemoperitoneo/diagnóstico por imagen , Humanos , Perforación Intestinal/complicaciones , Perforación Intestinal/diagnóstico por imagen , Laparoscopía/métodos , Laparotomía/métodos , Masculino , Enfermedades Raras , Medición de Riesgo , Tomografía Computarizada por Rayos X/métodos , Resultado del Tratamiento