Massive intra-abdominal hemorrhage from a hepatic laceration caused by vomiting

K. A. Horvath and A. H. Glasgow
Department of Surgery, Brigham and Women's Hospital, Boston, Mass. 02115.

We present a case report of a previously undocumented incident of massive hemoperitoneum from a liver laceration secondary to vomiting. The patient presented with the complaint of vomiting and abdominal pain. Computed tomography revealed perihepatic and perisplenic fluid collections. With this evidence and a rapidly falling hematocrit, she underwent emergency laparotomy. Intraoperative findings included 3 L of blood in the abdomen and a liver laceration at the juncture of the liver and the falciform ligament.