Idiopathic Neonatal Hemorrhagic Ascites: Conservative management is an option

Abstract

Idiopathic hemoperitoneum or hemorrhagic ascites is a very rare cause of fetal and neonatal ascites. It may be a life threatening condition which is challenging in diagnosis and treatment. We report a full term neonate who presented with cryptogenic massive hemorrhagic ascites and respiratory distress, but not anemia. All investigations failed to detect the underlying cause and attempts of therapeutic paracentesis failed due to the multilocular nature of the ascites. The ascites was self-limiting within a month. Peritoneal lavage and surgical exploration were not performed due to the regressive nature of ascites and absence of hemoglobin drop. After 18 months of follow up, the child was perfectly healthy, attained normal growth for age and did not suffer from intestinal obstruction or any other complication. Idiopathic hemorrhagic ascites can be self-limiting, conservative management and close follow up is an option.

Keywords

• hemorrhagic ascites
• anemia
• surgical exploration
• conservative management