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February 1979

Hemoperitoneum Associated With Exchange Transfusion Through an Umbilical Arterial Catheter

Author Affiliations

Department of Pediatrics; Department of Pathology Indiana University School of Medicine James Whitcomb Riley Hospital for Children 1100 W Michigan St Indianapolis, IN 46202

Am J Dis Child. 1979;133(2):216. doi:10.1001/archpedi.1979.02130020108021

The incidence of hemoperitoneum as a factor in neonatal deaths has been reported to approach 3%1; 70% to 80% of the cases are secondary to ruptured subcapsular hematomas of the liver.1.2 Perforation with subsequent hemoperitoneum has been reported as a complication of umbilical vessel catheter insertion.3.4 The following is a case of hemoperitoneum related to an exchange transfusion through an indwelling umbilical arterial catheter at 4 days of age. To our knowledge, hemoperitoneum resulting from this procedure has not been previously reported.

Report of a Case.—A 30-week gestation, 1,290-g male infant was admitted to James Whitcomb Riley Hospital for Children, Indianapolis, at 4 hours of age for treatment of severe respiratory distress. Chest roentgenogram was consistent with grade III hyaline membrane disease. Blood and suprapubic urine were obtained for culture and antibiotics were started. The clinical course was complicated by acidosis, shock, and hypoglycemia. At 90

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