Clinical

Hemoperitoneum refers to filling of the peritoneol cavity with gross blood. It can be secondary to trauma and laceration of internal organs (particularly the liver and spleen), surgery, or it may be due to spontaneous hemorrhage.

See Emergency Body CT for more detailed information.

Radiological findings

Many of the radiographic findings of hemoperitoneum are the same as those of ascites. CT may help determine the density of fluid including blood. The clotted component of a hemoperitoneum which has a higher attenuation on CT (45-60 HU), is likely to be found near the source of bleeding and this is known as the sentinel clot sign.

CT of hemoperitoneum (H) secondary to a splenic laceration with adjacent clot (C).

These two CT slices taken from the same patient show low attenuation peritoneal fluid adjacent to the liver (left) and of increased attenuation adjacent to the bowel (right) representing the source of the bleeding.