Protracted vomiting has been reported to produce gastrointestinal bleeding.1-4 However, these reports have emphasized disruption of continuity of a viscus, most commonly the esophagus, cardioesophageal junction, or stomach. Reports of intra-abdominal hemorrhage unassociated with injury to the gastrointestinal tract have emphasized some predisposing pathologic state. Arteriosclerosis and hypertension have been frequently associated with arterial hemorrhage.5,6 In the younger population spontaneous intraperitoneal hemorrhage has been associated with cirrhosis,7,8 pregnancy,9 and congenital anomalies.10 This report of intra-abdominal hemorrhage from a short gastric vein occurred after an episode of prolonged vomiting. This case was unusual because the site of blood loss was previously unrecorded and because no predisposing pathologic state was recognized.
Report of a Case
A 21-year-old white man was admitted to the Emergency Room of the Peter Bent Brigham Hospital with a 36-hour history of generalized abdominal pain. Forty-eight hours prior to admission the patient began