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Journal of Ultrasound

, Volume 22, Issue 4, pp 485–489 | Cite as

Added value of contrast-enhanced ultrasound (CEUS) with Sonovue® in the diagnosis of inferior epigastric artery pseudoaneurysm: report of a case and review of literature

  • Antonio CorvinoEmail author
  • Fabio Sandomenico
  • Sergio Venanzio Setola
  • Fabio Corvino
  • Fabio Pinto
  • Orlando Catalano
Case Report

Abstract

The anatomical position of the inferior epigastric artery (IEA), within the rectus sheath, subjects patients to possible IEA injury during abdominal wall surgical and interventional procedures. Pseudoaneurysm arising from IEA is very uncommon with only 16 cases reported in the literature. We present a case of an IEA false aneurysm resulting from therapeutic paracentesis for ascites in a 71-year-old patient who came to our department for abdominal pain and signs of anemization. To our knowledge, no published reports are currently available describing an IAE pseudoaneurysm successfully diagnosed with contrast-enhanced ultrasound.

Keywords

Iatrogenic pseudoaneurysm Inferior epigastric artery (IEA) Ultrasound imaging Contrast-enhanced ultrasound (CEUS) Sonovue® 

Notes

Author contributions

Each author has participated sufficiently in any submission to take public responsibility for its content.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Written informed consent was obtained from all patients, and the study was approved by the ethics committee of the institution.

Supplementary material

40477_2019_398_MOESM1_ESM.mp4 (1.2 mb)
Video 1On real-time US examination, a “smoky swarm” of small–medium echoes in a whirling motion (smoke-like effect, a very familiar finding to echocardiographers) is well appreciated within the hypo-anechoic area (MP4 1208 kb)
40477_2019_398_MOESM2_ESM.mp4 (1.2 mb)
Video 2Color-Doppler real-time video shows more clearly a pulsating color jet within the hypo-anechoic area synchronous with arterial pulse. This Doppler finding restricts the differential diagnosis (active bleeding or pseudoaneurysm) but does not permit further diagnostic evaluations (MP4 1195 kb)
40477_2019_398_MOESM3_ESM.mp4 (14.6 mb)
Video 3Real-time CEUS examination from the Sonovue® injection to 45 s allows us in observing the pulsating nature of the hyperechoic jets of contrast agent, which begins from the communication point with AEI, fill the PA cavity with a “whirling” appearance, up to a complete PA homogenization of during the late phase. In addiction, a slowly filling of the epigastric lymph node is also evident (MP4 14973 kb)

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Copyright information

© Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB) 2019

Authors and Affiliations

  1. 1.Motor Science and Wellness DepartmentUniversity of Naples “Parthenope”NaplesItaly
  2. 2.Radiology DepartmentNational Cancer Institute Pascale FoundationNaplesItaly
  3. 3.Vascular and Interventional Radiology DepartmentCardarelli HospitalNaplesItaly
  4. 4.Radiology DepartmentMarcianise HospitalMarcianiseItaly
  5. 5.Radiology UnitIstituto Diagnostico VarelliNaplesItaly
  6. 6.Casal di PrincipeItaly

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