Hemoperitoneo espontáneo: una complicación poco conocida y asociada al consumo de cocaína

Abstract

Spontaneous hemoperitoneum is a rare condition considered a medical emergency, usually diagnosed through exclusion. Among the main associated causes are congenital aneurysms, rupture of solid tumors, complications of peritoneal dialysis, and coagulopathies. In this article, we present the clinical case of a young man with no previous pathological or traumatic history, but with a history of cocaine use 24 hours before admission to the emergency room. He presented with generalized, sudden, and intense abdominal pain, and an abdominal ultrasound revealed free intraperitoneal fluid. He underwent exploratory laparotomy, which found 1200 mL of hemoperitoneum, completely evacuated. However, during the exploration of the cavity and subsequent follow-up in two new surgical procedures, the source of bleeding could not be identified. There were no recurrences or related complications during the follow-up.

Cocaine is an alkaloid with a powerful vasoconstrictor effect, generating endothelial lesions and an increase in blood pressure, resulting in the spontaneous rupture of blood vessels, constitutes a possible etiology of spontaneous hemoperitoneum.