Non-traumatic hemoperitoneum in the ED setting: causes, characteristics, prevalence and sex differences
Autor: | Vineet R. Jain, Meir H. Scheinfeld, Carly Schwartz, Inessa A. Goldman |
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Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
Radiological and Ultrasound Technology business.industry Obstetrics Urology Medical record Gastroenterology Emergency department Hepatology medicine.disease 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis Internal medicine Non traumatic medicine Etiology Ovarian cyst rupture Radiology Nuclear Medicine and imaging Cyst Hemoperitoneum medicine.symptom business |
Zdroj: | Abdominal Radiology. 46:441-448 |
ISSN: | 2366-0058 2366-004X |
Popis: | Prevalence and sex differences of non-traumatic hemoperitoneum in the Emergency Department has not been studied in the literature. Following IRB approval, multiple keyword searches were used to identify all cases of hemoperitoneum over a 55-month period. Cases were reviewed to confirm and quantify the hemoperitoneum. Maximum attenuation was used to grade blood density. Medical records were reviewed to determine cause, interventions and outcomes in each patient. Of the 171 verified cases of non-traumatic hemoperitoneum, 76% of cases were in women. CT exams in women were positive for hemoperitoneum 0.25% of the time, while 0.13% were positive in men. Regarding size, 25.7% were large, 24.5% were moderate and 49.7% were small. Contrast-enhanced studies had HU values of 103 ± 19 (range 47–146) which were significantly higher than for non-enhanced studies with values of 82 ± 19 (range 43–121, p < 0.001). The most common cause of non-traumatic hemoperitoneum was ruptured ovarian cyst which was found in 58% of women (76 cases). Of these, 69 patients received observation, 6 patients underwent surgery and 1 patient received Vitamin K. For the 95 non-ovarian cyst cases, 65% patients were admitted and then discharged, 22% were discharged from the ED, 12% expired and 1% were transferred to a different hospital. Post-procedure hemorrhage was the second to most common cause in women (24/130 = 18%) and the most common etiology in men (14/41 = 34%). In women, ovarian cyst rupture was the most common etiology of hemoperitoneum. Post-procedure hemorrhage was second in women and the most common etiology in men. Although unusual causes of hemoperitoneum will be encountered, understanding the most common causes of hemoperitoneum can provide a reasonable starting point when attempting to determine the most likely etiology of hemoperitoneum in any individual patient. |
Databáze: | OpenAIRE |
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