Hemoperitoneum may occur for a multitude of reasons, with CT imaging ( multiphase with high contrast flow rates ) being the typical initial investigation of choice.

It is important to try and establish:

1.  The source of the bleeding

2.  The status of the bleeding - is it active at the time of scanning? 

This is identified by observing the presence of active contrast extravasation ( ' the squirter' as our surgical colleagues would say ).

This patient proceeded to theater with hemorrhage occurring from a ruptured corpus luteum cyst.