Spontaneous hemoperitoneum due to rupture of the paraumbilical vein successfully treated with balloon-occluded retrograde transvenous obliteration

Kitagawa, Sho; Sato, Takahiro; Yamazaki, Katsu; Ohmura, Takumi; Karino, Yoshiyasu; Toyota, Jouji; Hasegawa, Takashi; Sakai, Wataru; Morita, Ryo

doi:10.1007/s12328-012-0349-7

Cited by 3 publications

(4 citation statements)

References 25 publications

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“…Spontaneous hemoperitoneum is defined as blood within the peritoneal cavity in the absence of a traumatic cause [ 1 ]. It is an uncommon condition, and fatal if treated inappropriately [ 2 ]. It is mostly caused by bleeding from tumors, gynecological causes and rupture of an intra-abdominal blood vessel in some vascular pathologies such as aneurysms and arteriovenous malformations.…”

Section: Discussionmentioning

confidence: 99%

“…It can show the presence of an intra-peritoneal effusion and the absence of other causes of bleeding (splenic rupture or hemorrhage from hepatocellular carcinoma). Shanmuganathan et al reported that attenuation values of active hemorrhage and clotted blood ranged from 85 to 370 HU (mean 132 HU) and 40 to 70 HU (mean 51 HU), respectively [ 2 , 9 ]. Interpretation of these results can sometimes be difficult for the radiologist, and this should not delay therapeutic management.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors suggest that arteriography and embolization has proved to be an inefficient investigation for diagnosis and treatment of retroperitoneal bleeding varices, it postpones the surgical treatment [ 6 , 8 ]. Others consider that it has a fundamental role in the treatment of intraabdominal vein rupture [ 2 , 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

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A Rare Cause of Spontaneous Hemoperitoneum: intra-abdominal Vein Rupture

et al. 2023

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Aim: Ruptures of the intra-abdominal vein causing a spontaneous hemoperitoneum in cirrhotic patients is a rare condition. However, diagnosis must be considered early in cirrhotic patients with hematic ascites as a delayed diagnosis with hemodynamic instability is associated with a poor prognosis. Case report: We present the case of a 54-year-old cirrhotic patient who presented a spontaneous hemoperitoneum due to the rupture of the intra-abdominal vein that was diagnosed during exploratory laparoscopy. Conclusion: Early diagnosis and management of spontaneous hemoperitoneum due to the rupture of intra-abdominal vein helps improve its prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A Rare Cause of Spontaneous Hemoperitoneum: intra-abdominal Vein Rupture

et al. 2023

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“…Arai et al showed that PTO (in failed BRTO cases) was technically successful in 44% of cases (technical success was defined as thrombosis of gastric varices on CT scan performed one week later) and when combined with standard BRTO, the success rate reached 100% (60). Sporadic case reports and case series have shown that this procedure is also effective in the treatment of ectopic varices (63,64).…”

Section: Complications and Outcomesmentioning

confidence: 99%

Percutaneous radiological interventions of the portal vein: a comprehensive review

2022

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The portal vein is the largest vessel supplying the liver. A number of radiological interventions are performed through the portal vein, namely for primary pathologies of the portal vein, for inducing liver hypertrophy or to treat the sequelae of portal hypertension among others. The routes used include direct transhepatic, transjugular, and, uncommonly, trans-splenic and through subcutaneous varices. Portal vein embolization and transjugular intrahepatic portosystemic shunt are among the most common portal vein interventions that are performed to induce hypertrophy of the future liver remnant and to treat complications of portal hypertension, respectively. Other interventions include transhepatic obliteration of varices and shunts, portal vein thrombolysis, portal vein recanalization, pancreatic islet cell transplantation, and embolization of portal vein injuries. We present a detailed illustrative review of the various radiological portal vein interventions.

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TIPS with a Twist � The Real Life Management of a Case of Budd-Chiarirelated Acute Liver and Subsequent Multiple Organ Failure

Craciun,

Chira,

Nemes

et al. 2023

CMIR

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Introduction: Budd-Chari syndrome (BCS) is a rare condition defined by the obstruction of hepatic venous outflow. BCS is a relatively infrequent cause of acute liver failure (ALF), accounting for less than 1% of cases. Treatment for acute BCS consists of a stepwise approach, requiring anticoagulation, angioplasty, transjugular intrahepatic portosystemic shunt (TIPS), and liver transplantation. Case Report: We present the case of a 31-year-old female patient with BCS, which led to ALF and subsequent multiple organ failure, which was successfully treated with TIPS and endovascular coil placement. Initial diagnostic workup revealed the complete obstruction of the hepatic venous outflow, spleno-mesenteric confluent thrombosis, and biochemical criteria of ALF. Her condition rapidly deteriorated towards multiple organ failure. At one point, the MELD score was 42, while the SOFA score predicted a mortality rate of >95%. Following continuous venovenous hemodiafiltration with cytokine adsorbent filters, TIPS was inserted, resulting in a portal pressure gradient (PPG) of 14 mmHg. Following TIPS, the patient had persistent ascites and later presented an episode of gastric variceal bleeding with endoscopic and surgical treatment failure. TIPS revision with further dilation led to a final PPG of 6 mmHg. During the procedure, selective embolization by coil placement of the spleno-gastric collateral circulation ultimately resolved the variceal bleeding. In the aftermath, the patient had complete organ failure remission and was successfully discharged with no ascites, encephalopathy, or significant impairment regarding daily life activities. Conclusion: In the rare setting of BCS complicated with ALF and portal hypertension-related complications, TIPS and endovascular embolization provide a unique, effective, and against-all-odd solution.

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Spontaneous hemoperitoneum due to rupture of the paraumbilical vein successfully treated with balloon-occluded retrograde transvenous obliteration

Cited by 3 publications

References 25 publications

A Rare Cause of Spontaneous Hemoperitoneum: intra-abdominal Vein Rupture

A Rare Cause of Spontaneous Hemoperitoneum: intra-abdominal Vein Rupture

Percutaneous radiological interventions of the portal vein: a comprehensive review

TIPS with a Twist � The Real Life Management of a Case of Budd-Chiarirelated Acute Liver and Subsequent Multiple Organ Failure

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