Hemoperitoneum is a type of internal bleeding. When you have this condition, blood is accumulating in your peritoneal cavity.
The peritoneal cavity is a small area of space located between your internal abdominal organs and your inner abdominal wall. Blood in this part of your body can appear because of physical trauma, a ruptured blood vessel or organ, or because of an ectopic pregnancy.
Hemoperitoneum can be a medical emergency. If you recognize any of the symptoms of this condition, you should seek attention from a doctor without delay.
Treatment for hemoperitoneum depends on the cause. Your treatment will begin with diagnostic testing to evaluate what exactly is causing internal bleeding. The diagnostic process will most likely take place in the emergency room.
If there’s reason to believe you have blood collecting in the peritoneal cavity, an emergency surgery may be performed to remove the blood and find where it’s coming from.
A ruptured blood vessel will be tied off to prevent more blood loss. If you have a ruptured spleen, it will be removed. If your liver is bleeding, the flow of blood will be controlled using blood-clotting drugs or other methods.
Depending on how long you’ve been bleeding, you may need a blood transfusion.
When hemoperitoneum is caused by an ectopic pregnancy, your method of treatment can vary according to how quickly blood is accumulating as well as other factors. You may need to be checked in to the hospital for observation once the ectopic pregnancy is discovered. Sometimes this kind of hemoperitoneum can be managed conservatively with drugs like methotrexate. In most cases, a laparoscopic surgery or a laparotomy to close your fallopian tube will be necessary.
When not treated promptly, serious complications can arise if you have hemoperitoneum. The peritoneal cavity is unique because it can hold almost all the circulating blood volume of the average person. It’s possible for blood to accumulate in the cavity extremely quickly. This can cause you to go into shock from blood loss, become unresponsive, and even result in death.
The symptoms of internal bleeding can be hard to catch unless there is a blunt trauma or accident that prompts a visit to the hospital. One study showed that even vital signs, like heart rate and blood pressure, can vary greatly from case to case.
Symptoms of internal bleeding in the pelvic or abdominal area can escalate and become the symptoms of shock. Some symptoms of hemoperitoneum include:
- tenderness at the site of your abdomen
- sharp or stabbing pain in your pelvic area
- dizziness or confusion
- nausea or vomiting
- cold, clammy skin
Car accidents and sports injuries account for some cases of hemoperitoneum. Blunt trauma or injury to your spleen, liver, bowels, or pancreas can all injure your organs and cause this kind of internal bleeding.
A common cause of hemoperitoneum is an ectopic pregnancy. When a fertilized egg attaches to your fallopian tube or inside your abdominal cavity instead of in your uterus, an ectopic pregnancy occurs.
This happens in 1 out of every 50 pregnancies. Since a baby can’t grow anywhere except inside of your uterus, this kind of pregnancy is unviable (incapable of growth or development). Endometriosis and the use of fertility treatments to get pregnant put you at greater risk for having an ectopic pregnancy.
Other causes of hemoperitoneum include:
- rupture of major blood vessels
- rupture of an ovarian cyst
- perforation of an ulcer
- rupture of a cancerous mass in your abdomen
Hemoperitoneum is diagnosed using several methods. If the doctor suspects that you’re bleeding internally, these tests will happen quickly to assess a plan for your care. A physical exam of your pelvic and abdomen area, during which your physician manually locates the source of your pain, may be the first step to diagnosing your situation.
In an emergency, a test called a Focused Assessment with Sonography for Trauma (FAST) test may be necessary. This sonogram detects blood that could be building up in your abdominal cavity.
A paracentesis may be conducted to see what kind of fluid is building up in your abdominal cavity. This test is conducted using a long needle that draws fluid out of your abdomen. The fluid is then tested.
A CT scan can also be used to detect hemoperitoneum.
The outlook for making a full recovery from hemoperitoneum is good, but only if you receive treatment. This isn’t a condition where you should “wait and see” if your symptoms or pain resolve on their own.
If you have any reason to suspect internal bleeding in your abdomen, don’t wait on seeking treatment. Call your doctor or an emergency helpline right away to get assistance.