July 1982

Intra-abdominal Hemorrhage From Ruptured Varices

Author Affiliations

From the Departments of Internal Medicine (Drs Crane and Bidari) and Surgery (Dr Jones), Veterans Administration Medical Center, Allen Park, Mich; and the Departments of Internal Medicine (Dr Fox) and Surgery (Dr Jones), Wayne State University School of Medicine, Detroit. Dr Fox is currently with Allentown and Sacred Heart Hospitals, Allentown, Pa.

Arch Surg. 1982;117(7):953-956. doi:10.1001/archsurg.1982.01380310059014

• Three patients with Laënnec's cirrhosis were initially seen with anemia, abdominal pain, and increased abdominal girth. Hemoperitoneum was diagnosed by paracentesis, and laparotomy revealed ruptured intraperitoneal varices. The two patients with more severe volume depletion died. The other patient, who was initially normotensive but had orthostatic changes, survived. A review of 11 previously reported cases is presented. Abdominal pain, hypotension, and increased abdominal girth were common initial findings, and should lead to early abdominal paracentesis. Suture ligation of the bleeding varix gives the greatest likelihood of survival.

(Arch Surg 1982;117:953-956)