Elucidating the etiology of idiopathic spontaneous intraperitoneal hemorrhage
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00179906%3A_____%2F25%3A10501595" target="_blank" >RIV/00179906:_____/25:10501595 - isvavai.cz</a>
Alternative codes found
RIV/00216208:11150/25:10501595
Result on the web
<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=MBQI9r1aQn" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=MBQI9r1aQn</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1111/1556-4029.70160" target="_blank" >10.1111/1556-4029.70160</a>
Alternative languages
Result language
angličtina
Original language name
Elucidating the etiology of idiopathic spontaneous intraperitoneal hemorrhage
Original language description
Free blood within the abdominal cavity (hemoperitoneum) presents a significant diagnostic and interpretive challenge. It may result from trauma or occur spontaneously in association with underlying disease conditions. When no source of fatal hemorrhage is identified, the implications extend across forensic, criminalistic, legal, and ethical domains. Idiopathic spontaneous intraperitoneal hemorrhage (ISIH), historically known as abdominal apoplexy, is characterized by fatal hemoperitoneum in the absence of trauma or known nontraumatic causes of intraabdominal bleeding. Rupture of a small intraabdominal vessel is suspected; however, the bleeding source usually remains unidentified. We report the case of a 45-year-old female with cirrhosis who succumbed to ISIH. Autopsy revealed massive hemoperitoneum and signs of exsanguination. Careful dissection of the abdominal cavity identified hemorrhagic ectopic venous varices beneath the right diaphragmatic arch, covered by an organized blood clot. Histological analysis confirmed recent hemorrhage and demonstrated suspected rupture of the parietal peritoneum near dilated ectopic venous varices. This case is evaluated in the context of pathophysiology, etiological theories, diagnostic limitations, potential contributions of imaging modalities, and forensic relevance. To our knowledge, this is the first reported case of ISIH with dual confirmation-both gross and histological-of hemorrhage originating from ectopic varices. These findings testify that rupture of ectopic venous varices may cause fatal hemorrhage in patients with cirrhosis and underscore the necessity of meticulous autopsy and histopathological correlation.
Czech name
—
Czech description
—
Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
—
OECD FORD branch
30501 - Forensic science
Result continuities
Project
—
Continuities
I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace
Others
Publication year
2025
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Journal of Forensic Sciences
ISSN
0022-1198
e-ISSN
1556-4029
Volume of the periodical
70
Issue of the periodical within the volume
6
Country of publishing house
US - UNITED STATES
Number of pages
7
Pages from-to
2565-2571
UT code for WoS article
001555917200001
EID of the result in the Scopus database
2-s2.0-105014120936