Haemoperitoneum is the presence of blood within the peritoneal cavity.

  • non-specific appearance of intra-peritoneal free fluid 4
    • may be hypo-, iso- or hyper-echoic 3
  • commonly will demonstrated fluid-fluid levels with mixed internal echogenicity 3

The density of fluid in the abdomen can be good guide to its composition (i.e. ascites/bowel contents/bile vs. haemorrhage) 1:

  • unclotted, fresh blood measures 30-45HU
  • clotted blood measures 45-70HU
  • old blood (<48 hours) or blood in patients with anaemia may measure < 30HU

Its appearance can be homogeneous or heterogeneous (often low density with internal linear/nodular hyperdensities) 5; fluid-fluid levels often present. 

  • acute (< 48 hours) haemoperitoneum has non-specific signal characteristics 5
  • subacute (> 3 weeks) may demonstrate concentric ring sign 5
  • fluid-fluid levels (haematocrit effect) with high T1/low T2 signal noted dependently 5
  • low-density haemoperitoneum may be indistinguishable from ascites or other causes of peritoneal free fluid 2 
  • an epicardial fat pad may mimic haemopericardium on FAST.
  • delayed contrast-induced dense ascites in which the attenuation of the low-density fluid increases post recent IV contrast administration (within up to 3 days). There may be a increase of up to 25HU 6
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Article information

rID: 20113
Section: Gamuts
Tags: stub, shetty, refs
Synonyms or Alternate Spellings:
  • Hematoperitoneum
  • Haemtaoperitoneum
  • Hemoperitoneum

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Cases and figures

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     Case 1
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    Case 2: haemoperitoneum and mesenteric hematoma
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    Case 3
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    Fluid extending t...
    Case 4
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    Case 5
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    Case 6: ruptured ectopic
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    Case 7: from HCC rupture
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