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Unusual cause of haemoperitoneum managed laparoscopically

A  33 year  female from Angola, Africa presented to Indraprastha Apollo Hospital with a 2 month history of progressive painless distension of the abdomen. Prior to presentation she had been diagnosed to have ascites (fluid in the abdomen) at another hospital. On two occasions 1 to 1.5 liters fluid had been removed from the abdomen which she described to he deep red in  colour. Evaluation at our hospital revealed the presence of  large  volume  ascites which was possibly related to Endometriosis suspected on MRI scan. She was planned for diagnostic laparoscopy which confirme d the  haemorrhagic ascites to be a result of oozing from one of the endometriotic nodules on the surface of the uterus. The bleeding was stopped successfully by laparoscopic cauterization. Post operatively the patient did well and there  has  been no recurrence of ascites after starting medical treatment for endometriosis.
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A STITCH IN TIME SAVES THE INTESTINE !!

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 Clinical History A 50 year female presented to the emergency of Metro Multispeciality Hospital with a h/o of acute abdominal pain and recurrent vomiting of 3-4 hours duration and a painful tender swelling in the mid abdomen. She gave a h/o of a swelling in the supra-umbilical region for the last 2-3 years. Clinical examination revealed a tender. Irreducible para-umbilical hernia. Large Irreducible Supraumbilical Swelling  Urgent CT abdomen confirmed a small intestinal loop to be stuck in the hernia sack. She was taken up for urgent laparotomy within 2 hours of presentation to the emergency . On opening the hernia sac a discoloured loop of small intestine was seen. The constricting ring was released and the intestine regained its normal colour and viability – allowing for the intestine to be saved. Patient underwent a Mesh Henioplasty and was discharged on the 2nd post operative day. TIMELY AND QUICK INTERVENTION SAVED THE PATIENT FROM AN INTESTINAL RESECTION AND ALLOWED FOR...
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