Pseudoaneurysm rupture causing hemoperitoneum following rectal impalement injury: A case report

Abstract

HighlightsRectal impalement injury may cause perirectal vascular injury.Pseudoaneurysm formation by rectal impalement injury is rare.Pseudoaneurysm rupture of the mid-rectal artery followed by massive hemoperitoneum after rectal impalement injury is extremely rare.Preoperative radiologic evaluation is crucial for definite surgical management.When surgery such as involved organ resection is indicated, pseudoaneurysm, which is bleeding focus, should be included in the surgical specimen.

Post-Traumatic Retroperitoneal Hematoma Caused by Superior Rectal Artery Pseudoaneurysm

“…Pseudoaneurysm is a perivascular hematoma that develops as the result of a partial disruption of the vascular layers, which maintains communication with the vascular structure [ 1 ].…”

“…The significant difference distinguishing pseudoaneurysm from aneurysm is the involvement of wall layers – a true aneurysm involves all vessel wall layers, while a pseudoaneurysm is only associated with partial wall layer involvement [ 1 ]. There are various known causes of pseudoaneurysm, most importantly infection, inflammation, and trauma [ 2 ].…”

“…Thus, given the serious risk of complications, especially with an associated rupture mortality risk of nearly 50%, early diagnosis and immediate appropriate management are essential [ 2 ]. For diagnosis, imaging must be performed, for which the criterion standard is conventional angiography [ 1 ]. However, due to limitations in personnel and facility capabilities, pseudoaneurysms are often diagnosed via other imaging modalities such as ultrasound or contrast-enhanced computed tomography [ 1 ].…”

“…For diagnosis, imaging must be performed, for which the criterion standard is conventional angiography [ 1 ]. However, due to limitations in personnel and facility capabilities, pseudoaneurysms are often diagnosed via other imaging modalities such as ultrasound or contrast-enhanced computed tomography [ 1 ]. Another benefit of diagnosing pseudoaneurysm via conventional angiography is that conventional angiography can concomitantly be therapeutic [ 1 ].…”

“…Pseudoaneurysm can be common within the human anatomy, in which a perivascular hematoma develops due to disruption of the vascular wall layers and results in a communicating hematoma [ 1 ]. This entity, although common in other vessels, is extremely rare in the superior rectal artery (SRA) and has been reported in only 7 published cases [ 2 – 8 ].…”