radiology imaging

1. Haemoperitoneum
The presence of bloon within the peritoneal cavity

2. Pathology
• Penetrating/non-penetrating abdominal trauma (associated with organ
injury)
• Rupture ectopic pregnancy
• Ovarian cysts rupture
• Anuerysma/pseudoaneurysma rupture
• Neoplasma rupture
• Acute haemorrhagic pancreatitis
• Iatrogenic
• Spontaneous bleeding, especially patient with coagulopathy/on
anticoagulant therapy

3. Ultrasound
• Non-specific appearance of intraperitoneal free fluid  may be hypo,
iso, hyperechoic
• May be demonstrate fluid-fluid levels with mixed internal
echogenesity

4. CT
• Density of fluid in the abdomen suggests its composition
- Acute hemorrhage  30-45 HU
- Clotted blood  45-70 HU
- Old blood product/seroma or blood in patient anaemia  <30 HU
• Can be homogenous/heterogenous (often low density with internal
linear/nodular hyperdensity
• Fluid-fluid level

5. MRI
• Acute (<48 Hours) haemoperitoneum has non-specific signal
characteristic
• Subacute (>3weeks)  Concentric ring sign
• Fluid-fluid levels (haematocrit effect) with high T1/low T2 signal noted
dependently

6. Differentiat diagnosis
• Low-density haemoperitoneum may be indistinguishable from
ascites/other causes of peritoneal free fluid
• Delayed inscrease attenuation of ascites after administration of IV
contrast
• Urine peritoneal cavity due to bladder injury