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

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Abstract

Purpose

To evaluate the etiology of unusual manifestation of hemoperitoneum and the efficacy of transcatheter arterial embolization (TAE).

Materials and methods

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.

Results

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.

Conclusion

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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Authors and Affiliations

  1. Department of Radiology and Research Institute of Medical Science, Konkuk University Hospital, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, 143-729, Seoul, Korea

    Sang Woo Park & Su Yeon Ko

  2. Department of Internal Medicine and Research Institute of Medical Science, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea

    So Young Yoon & Won Hyeok Choe

  3. Department of Surgery and Research Institute of Medical Science, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea

    Ik Jin Yun & Seong-Hwan Chang

  4. Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea

    Jong Yun Won

  5. Department of Radiology, Ansan Hospital, Korea University College of Medicine, Kyonggido, Korea

    Hwan Hoon Chung

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  1. Sang Woo Park
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  2. Su Yeon Ko
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  3. So Young Yoon
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  4. Won Hyeok Choe
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  5. Ik Jin Yun
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  6. Seong-Hwan Chang
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  7. Jong Yun Won
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  8. Hwan Hoon Chung
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Correspondence to Sang Woo Park.

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Park, S.W., Ko, S.Y., Yoon, S.Y. et al. Transcatheter arterial embolization for hemoperitoneum: unusual manifestation of iatrogenic injury to abdominal muscular arteries. Abdom Imaging 36, 74–78 (2011). https://doi.org/10.1007/s00261-010-9603-y

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  • DOI: https://doi.org/10.1007/s00261-010-9603-y

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