Idiopathic spontaneous lesser sac haematoma : a perplexing case of abdominal apoplexy
Cunha, Nikita Da. Narayanan, Aravindan Marimuthu, Kalimuthu Piramanayagam, Bala
Cunha, Nikita Da.
Narayanan, Aravindan
Marimuthu, Kalimuthu
Piramanayagam, Bala
Citations
Altmetric:
Affiliation
George Eliot Hospital
Other Contributors
Publication date
2017-08-18
Subject
Collections
Research Projects
Organizational Units
Journal Issue
Abstract
A 37-year-old woman presented with a 3-hour history of back pain, nausea and vomiting and an episode of syncope. A fluid collection in the lesser sac was detected on ultrasound and CT scan. Emergency laparoscopy and subsequent laparotomy were performed and a large blood clot was evacuated from the lesser sac. No identifiable source or predisposition to bleeding was found. She made a full recovery postoperatively. There are few reported cases of spontaneous intraperitoneal haemorrhage. In a third of cases, there is no identifiable source of bleeding. Unfortunately, patients present late with non-specific symptoms and a prompt diagnosis is difficult to make. The case reiterates the importance of awareness of lesser sac haematoma formation; an unusual clinical entity with a high morbidity and mortality rate. A high index of suspicion, radiological adjuncts and appropriate surgical intervention, especially in unstable patients, is essential for a good outcome.
Citation
Da Cunha N, Narayanan A, Marimuthu K, Piramanayagam B. Idiopathic spontaneous lesser sac haematoma: a perplexing case of abdominal apoplexy. BMJ Case Rep. 2017 Aug 18;2017:bcr2017220465. doi: 10.1136/bcr-2017-220465.
Type
Article