Blood in the belly: CT findings of hemoperitoneum

Meghan Lubner, Christine Menias, Creed Rucker, Sanjeev Bhalla, Christine M. Peterson, Lisa Wang, Brett Gratz

Research output: Contribution to journalReview article

91 Citations (Scopus)

Abstract

Hemoperitoneum may occur in various emergent conditions. In the trauma setting, evidence of intraperitoneal blood depicted at computed tomography (CT) should lead the radiologist to conduct a careful search of images for the injured visceral organ (the liver or spleen). Specific CT signs, such as a sentinel clot or extravasation of intravascular contrast material, may indicate the source of bleeding and help direct management. In addition, the configuration of accumulated blood may help identify the injured organ; for example, triangular fluid collections are observed in the mesentery most often in the setting of bowel or mesenteric injury. Less commonly, hemoperitoneum may have a nontraumatic origin. Iatrogenic hemoperitoneum may occur as a complication of surgery or other interventional procedures in the abdominal cavity or as a result of anticoagulation therapy. Hemoperitoneum also may be seen in the setting of blood dyscrasias such as hemophilia and polycythemia vera. Tumor-associated hemorrhage, which most often occurs in hepatocellular carcinoma, hepatic adenoma, or vascular metastatic disease, also may produce hemoperitoneum. Other potential causes of nontraumatic hemoperitoneum are gynecologic conditions such as hemorrhage or rupture of an ovarian cyst and rupture of the gestational sac in ectopic pregnancy, and hepatic hematoma in syndromic hemolysis with elevated liver enzymes and low platelet count (HELLP syndrome). Vascular lesions (visceral artery aneurysms and pseudoaneurysms) that occur in systemic vascular diseases such as Ehlers-Danlos syndrome or in pancreatitis are another less common source of hemoperitoneum.

Original languageEnglish (US)
Pages (from-to)109-125
Number of pages17
JournalRadiographics
Volume27
Issue number1
DOIs
StatePublished - Jan 1 2007

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Hemoperitoneum
Tomography
Liver
Hemorrhage
Vascular Diseases
Rupture
Gestational Sac
HELLP Syndrome
Ehlers-Danlos Syndrome
Polycythemia Vera
Ovarian Cysts
Mesentery
Abdominal Cavity
Ectopic Pregnancy
False Aneurysm
Wounds and Injuries
Hemophilia A
Hemolysis
Platelet Count
Hematoma

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Lubner, M., Menias, C., Rucker, C., Bhalla, S., Peterson, C. M., Wang, L., & Gratz, B. (2007). Blood in the belly: CT findings of hemoperitoneum. Radiographics, 27(1), 109-125. https://doi.org/10.1148/rg.271065042
Lubner, Meghan ; Menias, Christine ; Rucker, Creed ; Bhalla, Sanjeev ; Peterson, Christine M. ; Wang, Lisa ; Gratz, Brett. / Blood in the belly : CT findings of hemoperitoneum. In: Radiographics. 2007 ; Vol. 27, No. 1. pp. 109-125.
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Lubner, M, Menias, C, Rucker, C, Bhalla, S, Peterson, CM, Wang, L & Gratz, B 2007, 'Blood in the belly: CT findings of hemoperitoneum', Radiographics, vol. 27, no. 1, pp. 109-125. https://doi.org/10.1148/rg.271065042

Blood in the belly : CT findings of hemoperitoneum. / Lubner, Meghan; Menias, Christine; Rucker, Creed; Bhalla, Sanjeev; Peterson, Christine M.; Wang, Lisa; Gratz, Brett.

In: Radiographics, Vol. 27, No. 1, 01.01.2007, p. 109-125.

Research output: Contribution to journalReview article

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AU - Menias, Christine

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Lubner M, Menias C, Rucker C, Bhalla S, Peterson CM, Wang L et al. Blood in the belly: CT findings of hemoperitoneum. Radiographics. 2007 Jan 1;27(1):109-125. https://doi.org/10.1148/rg.271065042