Spontaneous Hemoperitoneum Due To Necrotic Omental Tumour-A Case Report

Hemoperitoneum due to bleeding from intra-abdominal tumours is relatively rare. We report an unusual case of acute abdomen with hemoperitoneum due to bleeding from omentum mimicking a tumour bleed. A 25 year-old-male presented to us with complaints of abdominal pain and distention. Computed tomography revealed a 12 x10 cm heterogeneous mass along the greater curvature of stomach with significant hemoperitoneum. An emergency laparotomy was performed. Intra-operatively, 3000 ml of dark blood, and a hemorrhagic necrotic mass in the gastrosplenic omentum was found. Resection of the mass was performed. Histopathology revealed a hemorrhagic necrotic mass, with no viable tissue. Since there was no viable tissue, the nature of the tumor could not be diagnosed. Regular follow-up is planned in view of the uncertain nature of primary tumour. The differential diagnosis includes a wide variety of benign and malignant tumours, trauma, infarction and vascular causes. Omental tumours should be included in the differential diagnosis of spontaneous hemoperitoneum. The treatment of choice is complete excision of the tumour in view of the multitude of causes and possibility of malignancy.