RESUMEN
Hemoperitoneum is a serious and often life-threatening bleeding manifestation. This is particularly true for women who carry congenital bleeding disorders. We describe here a hemoperitoneum occurring in 1 patient with congenital prothrombin deficiency and another with congenital factor V deficiency. Both patients have been followed by us for many years. The patient with prothrombin deficiency underwent laparoscopy but was treated consecutively with whole blood, plasma transfusions and 1,000 units of prothrombin complex concentrates. Response was good and she was then placed on oral contraceptives (OC) which prevented any recurrence. The patient with factor V deficiency presented several episodes of ovulation-related bleeding which required hospitalization and fresh frozen plasma transfusions. On the fifth occasion, the patient had to undergo surgery, and a left oophorectomy was carried out. After this last episode, she was also placed on OC which were very effective in preventing further recurrences. Both patients tolerated the medications very well which, in addition, were able to control menometrorrhagia with a consequent decrease over time in transfusional needs. OC are the treatment of choice in congenital bleeding disorders to control both the menorrhagia and, more importantly, ovulation-related hemoperitoneum.
Asunto(s)
Anticonceptivos Orales/administración & dosificación , Deficiencia del Factor V/complicaciones , Hemoperitoneo/etiología , Hemoperitoneo/prevención & control , Hipoprotrombinemias/complicaciones , Inhibición de la Ovulación/efectos de los fármacos , Adulto , Transfusión de Componentes Sanguíneos/métodos , Deficiencia del Factor V/terapia , Femenino , Hemoperitoneo/terapia , Humanos , Hipoprotrombinemias/terapia , Laparoscopía/métodos , Menorragia/prevención & control , RecurrenciaRESUMEN
Ascitic fluid samples from 10 patients with ovarian carcinoma and 10 with cirrhosis of the liver were examined for their content of components of the fibrinolytic system. Large amounts of fibrin/fibrinogen degradation products (F.D.P.) were found in the ascitic fluid in all patients with malignant tumors, but not in the other group. Determination of F.D.P. may therefore make it possible to differentiate between malignant and non-malignant ascitic fluid.