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JAMA Surgery Clinical Challenge
June 2014

Traumatic Hemoperitoneum

Author Affiliations
  • 1Division of Trauma and Critical Care, Department of Surgery, The Johns Hopkins Hospital, Baltimore, Maryland
JAMA Surg. 2014;149(6):615-616. doi:10.1001/jamasurg.2013.123

A 33-year-old woman presented to the emergency department as a restrained driver in a motor vehicle collision with air bag deployment. The patient had diffuse lower abdominal pain with nausea and one episode of emesis. Her vital signs were notable for a blood pressure of 108/69 mm Hg and a heart rate of 124 beats/min. Physical examination findings revealed tachycardia and a distended, diffusely tender abdomen without evidence of a seatbelt sign or peritonitis. Her laboratory findings were unremarkable except for a hemoglobin level of 10.5 g/dL (to convert to grams per liter, multiply by 10) and a white blood cell count of 21 300/μL (to convert to ×109/L, multiply by 0.001). Her medical history was significant only for asthma.

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