ACUTE HEMORRHAGIC ABDOMEN IN YOUNG PATIENTS: CLINICAL MANIFESTATIONS AND SURGICAL TREATMENT
Authors: Oliveira Pamella Naves de , Rocha Breno Henrique , Castro Ana Elisa de , Souza Sarah Cristina Durães de , Souza Marcos Vinícius Magalhães e , Lourenço Lourdes da Cruz Balta , Porfirio Vanessa Fontana , Machado Milena Arpini , Vales Eloisy Stefany de Souza , Salgado Gabriel Faria Campos , Silva Thamires Bárbara Cardoso da , Bramatti Sayonara Aparecida , Oliveira Gabriel Felipe 
Published: July 2024

Acute hemorrhagic abdomen represents a surgical emergency that requires rapid diagnosis and immediate treatment. In young patients, the most common causes include perforated peptic ulcer, ruptured ectopic pregnancy, ovarian cyst torsion, and abdominal trauma. The clinical presentation is variable, but intense and sudden abdominal pain, associated with signs of hypovolemic shock (hypotension, tachycardia, pallor), is characteristic. Delay in diagnosis and treatment can lead to serious complications, such as hemodynamic instability, infection and death. Objective: The objective of this systematic review was to synthesize the available scientific evidence on the clinical manifestations and surgical treatment of acute hemorrhagic abdomen in young patients, with the aim of assisting health professionals in decision-making and therapeutic planning. Methodology: A systematic review of the literature was carried out, following the PRISMA checklist criteria. The PubMed, Scielo and Web of Science databases were searched using the following descriptors: “acute abdomen”, “hemorrhagic abdomen”, “young people”, “surgery”, “emergency”. Original articles published in the last 10 years were included, which addressed young patients diagnosed with acute hemorrhagic abdomen and described the clinical manifestations of the disease and the results of surgical treatments. Case studies, narrative reviews and articles that were not available in full were excluded. Results: The review identified a total of 17 studies that addressed acute hemorrhagic abdomen in young patients. The results demonstrated that intense and sudden abdominal pain is the most common symptom, often associated with nausea, vomiting and bloating. The presence of signs of peritoneal irritation, such as muscle guarding and pain upon sudden decompression, is suggestive of peritonitis. Complementary tests, such as blood count, coagulogram and computed tomography, are essential for diagnosing and staging the disease. The treatment of acute hemorrhagic abdomen is surgical and aims to control bleeding, remove the cause of hemorrhage and repair tissue damage. Exploratory laparotomy remains the gold standard for treatment, although laparoscopy has become increasingly popular in specialist centers. Conclusion: Acute hemorrhagic abdomen in young patients is a surgical emergency that requires a quick and effective approach. Early diagnosis and surgical treatment are essential for the patient's survival. High clinical suspicion, associated with the performance of appropriate complementary tests, allows diagnosis and initiation of treatment in a timely manner. Exploratory laparotomy remains the procedure of choice, but laparoscopy has proven to be a safe and effective alternative in many cases.