Idiopathic intrahepatic arterioportal shunt rupture

A 70-year-old Thai female end-stage renal disease (ESRD) patient, with a 4 years history of peritoneal dialysis, was brought to the emergency department because of syncope after her regular peritoneal dialysis, and a mixture of fluid and blood was obtained from the peritoneal fluid. Blood loss was suspected from her physical examinations and labs. Her past medical history showed hypertension, dyslipidemia, ischemic stroke, causing right hemiparesis 10 years ago and aspirin (ASA) has been prescribed.