Background: Haemoperitoneum should be open or not? – it is the dilemma that every surgeon come across whenever a case of hemoperitoneum arrives in emergency..!! Here we have tried to highlight the criteria which will be helpful in this regards.

Aims & objective: This study was carried out to evaluate the results and to find out the criteria for decision–making for conservative or operative management in a case of hemoperitoneum.

Methods : 200 patients admitted during  MAY 2014 TO MAY 2016 with hemoperitoneum were enrolled for the study and cases were evaluated for various variables like demographic data, injury classification, associated lesions, treatment, transfusions, morbidity and mortality, and hospital stay.

Results : Out of total 200 patients, 76 patients was operated within 8 hours, out of which 22 patients underwent negative laparotomy. The remaining 124 patients were managed conservatively out of which 24 patients underwent laparotomy later because of the failure of the conservative management. Criteria which led to failure of conservative management and criteria which led to negative operative approach is discussed here.

conclusions : Conservative treatment is an adequate treatment in a great number of patients. Failure of conservative treatment did not show a higher incidence of complications or mortality but it should be performed in centers with experienced surgeons.