الفهرس 
Surgical anatomy of the peritoneum
Ruptured hepatic secondariesOnly 14 pages are availabe for public view
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Abstract
Non-traumatic intraperitoneal bleeding or Spontaneous hemoperitoneum is defined as the presence of blood within the peritoneal cavity that is unrelated to trauma. It may be idiopathic or related to spontaneous rupture of either a known or an unknown pathology. There are a myriad of causes for spontaneous hemoperitoneum and an underlying cause should always be looked for if the patient survives the initial event. The causes of spontaneous hemoperitoneum may be grouped into hepatic causes, splenic causes, gynecological causes, vascular causes, and altered coagulation status . The initial diagnosis should be suspected on clinical basis as the patient may be present with severe abdominal pain and distention, a decreased hematocrit level, or, more rarely, hypovolemic shock. The initial CT scanning or abdominal ultrasonography may diagnose the cause of bleeding on initial scanning in the hands of expert radiologist. The modality of treatment depends on the presenting symptoms of the patient in the emergency room. If the patient is stable, this allows rapid surgical or interventional haemostatic procedures to stop bleeding. But if the patient is clinically unstable this favors conservative treatment until the patient condition improves or perform staged surgical resection later on.