Laparoscopic Management of Abdominal Apoplexy

Idiopathic Spontaneous Intraperitoneal Haemorrhage (ISIH): A Diagnostic Dilemma and Its Conservative Management

Idiopathic spontaneous intraperitoneal haemorrhage (ISIH) is a rare cause of acute abdominal pain. It refers to haemoperitoneum resulting from the rupture of an intra-abdominal vessel without the preceding trauma or underlying pathology. Here, we present the case of a 17-year-old boy with acute abdominal pain. Initially, acute appendicitis was the primary differential diagnosis. Imaging demonstrated a significant volume of intra-abdominal fluid that was haemorrhagic in nature, but no active bleeding or source was identified. A conservative management approach was adopted due to the patient's clinical improvement during his admission. This case highlights the high index of clinical suspicion required to diagnose and investigate ISIH. In contrast to the historical opinion that stipulates management with a surgical intervention, this case demonstrates the possibility of conservative management in stable patients.

Case report: Laparoscopic treatment of gastro-omental hemangioma with hemorrhage: two cases reports and review of literature

BACKGROUND

Spontaneous hemorrhage of gastro-omental hemangioma is a rare disease. The treatment strategy for this disease changes as it develops. In the acute stage, surgery is the first priority, among which laparoscopic treatment should be the most frequently considered option in large general hospitals. Due to the rarity of this disease, such cases have rarely been reported.

CASE DESCRIPTION

We present the first report of two eldely cases with gastro-omental hemangioma with hemorrhage by laparoscopic treatment. Both cases were initially admitted with upper abdominal pain, and abdominal computed tomography (CT) scan revealed masses alongside the greater curvature of the stomach. Laparoscopic surgery was conducted immediately in both patients. The two cases recovered well after surgery, and no obvious abnormalities were observed in the follow-up period.

CONCLUSION

Gastro-omental hemangioma rupture remains an uncommon cause of intraperitoneal hemorrhage. Timely diagnosis and surgery are paramount for treatment. Medical institutions with the correct technology and equipment should perform laparoscopic treatment to minimize surgical trauma and promote rapid recovery of patients with abdominal apoplexy.

Idiopathic Spontaneous Intraperitoneal Hemorrhage due to Rupture of Short Gastric Artery Presenting as Massive Gastrointestinal Bleeding: A Rare Case Presentation and Literature Review

Idiopathic spontaneous intraperitoneal hemorrhage (ISIH) or abdominal apoplexy is due to the tear of an intra-abdominal visceral vessel spontaneously where no cause can be identified. It is an uncommon but potentially life-threatening condition that generally shows up as a diagnostic dilemma as well as is related to formidable mortality. Among all the reported cases, the extemporaneous tear of short gastric arteries is extremely rare, but it has never been reported to present with massive gastrointestinal bleeding. We report a rare instance of idiopathic spontaneous intraperitoneal hematoma eroding the stomach wall, causing massive gastrointestinal bleeding.