Omental venous malformation: a rare cause of spontaneous haemoperitoneum

Abstract

Spontaneous haemoperitoneum is a rare condition with a variety of aetiologies. Regardless of the cause, it is invariably a life-threatening condition that requires urgent diagnosis and management. The most common causes of spontaneous haemoperitoneum include gynaecological, hepatic, splenic and vascular causes. However, here, we present a rare case of spontaneous haemoperitoneum secondary to idiopathic omental venous malformation.Our patient presented with acute onset of right iliac fossa pain, and a CT scan revealed a massive haemoperitoneum. A laparoscopic converted to open laparotomy was performed to diagnose and treat the patient. We discuss the management approach for such patients with spontaneous haemoperitoneum.

Keywords: General surgery; Radiology.

Figure 1

Contrast-enhanced (A) axial and (B) coronal CT images show a large hyperdense haematoma (both arrows) in the right iliac fossa.

Figure 2

Contrast-enhanced axial CT image shows fluid (arrow) in the pelvis with hematocrit level, consistent with haemoperitoneum.

Figure 3

HE ×100. Photomicrograph showing malformed veins (arrows) in the centre featuring eccentric thickening of the wall.