Abdominal Apoplexy: A Case Study of Idiopathic Spontaneous Lesser Sac Hematoma (original) (raw)
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Abdominal apoplexy: A case study of the spontaneous rupture of the gastroepiploic artery
Current Surgery, 2004
This is a case report of abdominal apoplexy (AA) or spontaneous rupture of a visceral vessel, without associated aneurysmal dilation of the vessel. Spontaneous rupture of the left gastroepiploic artery (LGEA) resulting in a hemoperitoneum is discussed. The clinical presentation of left lower quadrant abdominal pain, along with the histologic findings of medial degeneration of the LGEA, makes this case an unusual one. The incidence, origin, associated predisposing medical conditions, clinical presentation, and treatment of abdominal apoplexy are discussed. (Curr Surg 61:370-372. © 2004 by the Association of Program Directors in Surgery.) KEY WORDS: gastroepiploic artery rupture, hemoperitoneum, hemorrhage, laparotomy Correspondence: Inquiries to Mehul Jadav, MD, 20135 Keswick St.,
Rupture of middle colic artery pseudoaneurysm
The American Journal of Emergency Medicine, 2013
A 61-year-old man with acute onset of epigastric discomfort with hemorrhagic shock was diagnosed of rupture of middle colic artery (MCA) pseudoaneurysm by computed tomography of abdomen with contrast enhancement. After consulting the general surgeon and the radiologist, transcatheter arterial embolization was arranged. Aneurysms from superior mesenteric arterial branch, especially MCA aneurysm, are extremely rare. Conservative treatment may be considered if the patient is clinically stable and no evidence of indicating ruptured aneurysm or ischemic bowel change. In the past era, surgical intervention is the treatment of choice for rupture of visceral artery aneurysms. We describe a rare case of rupture of MCA pseudoaneurysm managed with transcatheter arterial embolization successfully under hemodynamic unstable situation without further laparotomy. As the improvement and development of interventional vascular techniques, endovascular therapy may be considered as an alternative and safe therapy.
Laparoscopic Management of Abdominal Apoplexy
2019
Abdominal apoplexy, otherwise known as intraperitoneal idiopathic spontaneous haemorrhage, is a rare condition that presents as a diagnostic dilemma and is associated with high mortality. Symptoms and signs typically are similar to other conditions presenting with upper abdominal peritonitis. Intraabdominal haemorrhage can occur from many different causes, including trauma, iatrogenic, ruptured aneurysm, gynaecological conditions, malignancy, and inflammatory or autoimmune processes. Spontaneous or idiopathic causes are much rarer. Prompt diagnosis and ligation of the bleeding vessel usually result in a good outcome. Most cases described involve males in the fifth and sixth decade of life who present in the setting of hypertension and known atherosclerotic disease and are managed with laparotomy or are diagnosed at autopsy. We present a case of abdominal apoplexy managed laparoscopically in a healthy 20-year-old male with no pre-existing medical conditions. This case highlights the ...
Caspian Journal of Internal Medicine, 2021
Background: Abdominal apoplexy is one of the rare causes of non-traumatic intraabdominal bleeding. This condition is usually seen in male patients in their 50s with history of hypertension. As soon as abdominal apoplexy is suspected, immediate resuscitation should be performed followed by emergent surgery. The patient's outcome depends entirely on the clinical condition and the time interval between diagnosis and treatment. Case Presentation: Herein we present a 63-year-old man with idiopathic spontaneous intraperitoneal hemorrhage (ISIH) caused by spontaneous rupture of non-aneurysmal inferior pancreaticoduodenalartery (IPDA). Conclusion: In this report, a case of abdominal apoplexy has been presented caused by spontaneous rupture of non-aneurysmal inferior pancreaticoduodenalartery (IPDA) in a patient without any significant past medical history.
A Rare Cause of Hemoperitoneum: A Case Report of Ruptured Ileocolic Artery Aneurysm
Turkish Journal of Trauma and Emergency Surgery
Visceral artery aneurysm (VAA) is very rare among vascular pathologies. Incidence reported in autopsy series and angiographic studies varies between 0.1% and 0.2%. Most cases are asymptomatic and are diagnosed as result of complications, or incidentally, when imaging is performed for another reason. Three percent of VAAs are superior mesenteric artery (SMA) terminal branch aneurysms. Intra-and/ or extraperitoneal bleeding due to ruptured aneurysm is life-threatening condition and requires emergent intervention. Therefore, surgical or endovascular interventional treatment must be performed rapidly after diagnosis. Presently described is case of ileocolic artery aneurysm in a patient admitted with abdominal pain, nausea, and vomiting. Endovascular intervention had been planned; however, during hospitalization, aneurysm ruptured and emergent surgery was performed. Review of the literature is also presented.
Abdominal Vascular Catastrophes
Emergency medicine clinics of North America, 2016
Abdominal vascular catastrophes are among the most challenging and time sensitive for emergency practitioners to recognize. Mesenteric ischemia remains a highly lethal entity for which the history and physical examination can be misleading. Laboratory tests are often unhelpful, and appropriate imaging must be quickly obtained. A multidisciplinary approach is required to have a positive impact on mortality rates. Ruptured abdominal aortic aneurysm likewise may present in a cryptic fashion. A specific type of ruptured aneurysm, the aortoenteric fistula, often masquerades as the more common routine gastrointestinal bleed. The astute clinician recognizes that this is a more lethal variant of gastrointestinal hemorrhage.
An unusual cause of lower gastrointestinal haemorrhage
BMJ case reports, 2011
A previously unreported cause of lower gastrointestinal haemorrhage in a 63-year-old female patient on clopidogrel for cardiac comorbidities is presented. Endoscopy suggested a small bowel or colonic aetiology but failed to accurately localise the source. The patient became haemodynamically unstable despite conservative management and temporary cessation of clopidogrel. CT angiography demonstrated a pseudoaneurysm arising from the superior rectal artery. Percutaneous embolisation using coils was performed to successfully occlude the pseudoaneurysm, prevent further haemorrhage and avoid emergency colonic resection.