Spontaneous Hemoperitoneum Due To Necrotic Omental Tumour-A Case Report

Abstract

Hemoperitoneum due to bleeding from
intra-abdominal tumours is relatively
rare. We report an unusual case of acute
abdomen with hemoperitoneum due to
bleeding from omentum mimicking a tumour
bleed. A 25 year-old-male presented
to us with complaints of abdominal
pain and distention. Computed tomography
revealed a 12 x10 cm heterogeneous
mass along the greater curvature
of stomach with significant hemoperitoneum.
An emergency laparotomy was
performed. Intra-operatively, 3000 ml of
dark blood, and a hemorrhagic necrotic
mass in the gastrosplenic omentum was
found. Resection of the mass was performed.
Histopathology revealed a hemorrhagic
necrotic mass, with no viable
tissue. Since there was no viable tissue,
the nature of the tumor could not be diagnosed.
Regular follow-up is planned in
view of the uncertain nature of primary
tumour. The differential diagnosis includes
a wide variety of benign and malignant
tumours, trauma, infarction and
vascular causes. Omental tumours
should be included in the differential diagnosis
of spontaneous hemoperitoneum.
The treatment of choice is complete excision
of the tumour in view of the multitude
of causes and possibility of malignancy.