Patients may be asymptomatic for a significant period of time after the initial event that caused bleeding, but the clinical presentation may include varying degrees of abdominal or pelvic pain and discomfort, hypotension, fatigue, and weakness. Blood loss may lead to shock and compartment syndrome in severe cases , which is why the focus should be on an early diagnosis.
A thorough patient history can provide important details regarding the underlying cause, but the radiographic assessment is vital in diagnosing hemoperitoneum. Ultrasonography is a very good initial method of detecting fluid in the peritoneal cavity in emergency settings but computed tomography is the gold standard . Due to its speed and increased sensitivity for small blood effusions, it is more commonly used. Moreover, the highest attenuation is seen closest to the site of bleeding (as a result of accelerated clotting), whereas lower-attenuated unclotted blood is located at the periphery, which can suggest the source of bleeding .
Conditions in which hemoperitoneum may develop as a complication include     :
Some studies suggest that hemoperitoneum is more frequently seen in women due to its association with several gynecologic disorders . Its occurrence in clinical practice, however, remains unknown.
Vascular injury and subsequent hemorrhage into the peritoneal cavity is the main pathological mechanism of hemoperitoneum.
Early recognition of bleeding may be one of the most important strategies in preventing the onset of more severe complications that may endanger the patient's life.
Hemoperitoneum is a clinical entity describing the accumulation of blood in the peritoneal sac, which can occur due to trauma, surgery and a range of gynecologic, hepatic, vascular, renal, neoplastic or hematologic conditions  . Regardless of the cause, a varying amount of blood pools into the peritoneum and the importance of an early diagnosis lies in preventing the onset of life-threatening blood loss. Abdominal pain and weakness are main clinical features. Ultrasonography and computed tomography (CT) are used to make the diagnosis and confirm the presence of blood in the peritoneum, as well as the source of bleeding . Emergency embolization or surgery are necessary therapeutic procedures .
Hemoperitoneum is a condition in which blood accumulates in the space between in the peritoneum, a membrane covering the majority of abdominal organs. Most important causes include trauma to the abdomen, injury during surgical or diagnostic procedures, gynecologic disorders (ectopic pregnancy, rupture of ovarian cysts) and tumor-associated bleeding (seen in liver cancer). As the blood leaks from damaged vessels into the peritoneum, signs of shock may appear - decreased blood pressure and profound weakness. Blood loss may be life-threatening, which is why an early diagnosis is necessary and imaging studies such as ultrasonography and computed tomography of the abdomen are recommended. Surgical repair of injured organs and vessels is the mainstay of treatment.