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Transcatheter arterial embolization for hemoperitoneum: unusual manifestation of iatrogenic injury to abdominal muscular arteries

Authors
Park, Sang WooKo, Su YeonYoon, So YoungChoe, Won HyeokYun, Ik JinChang, Seong-HwanWon, Jong YunChung, Hwan Hoon
Issue Date
2월-2011
Publisher
SPRINGER
Keywords
Hemoperitoneum; Angiography; Interventional radiology; Embolization; Etiology
Citation
ABDOMINAL IMAGING, v.36, no.1, pp.74 - 78
Indexed
SCIE
SCOPUS
Journal Title
ABDOMINAL IMAGING
Volume
36
Number
1
Start Page
74
End Page
78
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/113103
DOI
10.1007/s00261-010-9603-y
ISSN
0942-8925
Abstract
To evaluate the etiology of unusual manifestation of hemoperitoneum and the efficacy of transcatheter arterial embolization (TAE). A retrospective review of patients at three hospitals was performed. A total of 12 patients (M:F = 5:7, mean age: 48) had massive hemoperitoneum without evidence of an intramuscular hematoma on CT (n = 10) or US (n = 2) after injury to the abdominal wall. The patients underwent TAE. The etiology of iatrogenic injury to the abdominal muscular arteries and the effectiveness of embolization were evaluated. Among 12 patients, 11 patients had injuries to the inferior epigastric artery (IEA) and one patient had an injury to the deep circumflex iliac artery (DCIA). The causes of the injuries were: paracentesis (n = 6), open laparotomy (n = 4), removal of a CAPD catheter (n = 1), and surgical drain (n = 1). The TAE was successfully performed in all patients. Over 10 days of follow-up after the embolization, all patients were stabilized hemodynamically. Injury to the IEA or DCIA should be considered as a possible source of hemoperitoneum even in patients with no evidence of an intramuscular hematoma after injury to the superficial arteries of the abdominal wall. In addition, such injuries can be treated successfully using TAE.
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