• HPB Surg · Jan 2009

    Case Reports

    Hemoperitoneum in a cirrhotic patient due to rupture of retroperitoneal varix.

    • Igor Rafael Sincos, Grace Mulatti, Sheila Mulatti, Ilana Cristina Sincos, Sergio Q Belczak, and Valdir Zamboni.
    • Department of General Surgery of Universitary Hospital and Clinics Hospital, University of São Paulo Medical School (FMUSP), 05403-000 São Paulo, SP, Brazil. igorsincos@gmail.com
    • HPB Surg. 2009 Jan 1; 2009: 240780.

    AbstractThe rupture of retroperitoneal varices is a rare and catastrophic complication of portal hypertension. We describe a case of this nature, the first in Brazilian medical literature, and also reviewing all previous 34 cases. We systematically analyzed all therapeutic approach and propose a management algorithm for diagnosis and treatment of this lethal condition. The majority of the patients presented with abdominal pain, distention and hypotension, and developed hemorrhagic shock. Rupture of retroperitoneal varices can be properly managed if an early diagnosis is made and surgery is performed promptly, which is the only effective treatment. Arteriography should be used when the suspicion is of rupture of hepatocellular carcinoma.

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