Spontaneous rupture of a left omental artery aneurysm treated by transcatheter arterial embolization: A case report

Maghrebi, Houcine; Zaiem, Asma; Beji, Hazem; Jeribi, Bedis; Hadded, Anis; Frikha, Wassim; Hamissa, Selim; Jouini, Mohamed; Kacem, Montasser

doi:10.1016/j.amsu.2022.104704

Cited by 4 publications

(5 citation statements)

References 13 publications

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“…The results of the present study are comparable with those of several previous OAA case reports. 3,4,16,17 TAE is a minimally invasive, effective, and safe treatment option for ruptured as well as unruptured OAA cases. Packed red blood cell transfusion was performed only in cases with ruptured OAAs, and more contrast medium during TAE was also used in cases with ruptured OAAs due to the necessity of checking complete hemostasis while performing multiple angiograms; however, no significant differences were observed in the hospitalization period or duration of TAE fluoroscopy.…”

Section: Discussionmentioning

confidence: 99%

“…1 Various methods of treating ruptured OAA, such as omentectomy and transcatheter arterial embolization (TAE), have been described previously. [2][3][4] As a mortality rate as high as 70% is associated with ruptures, elective intervention is recommended for the treatment of unruptured OAA regardless of their size. 1 Transcatheter arterial embolization has been widely accepted as the first-line treatment of VAAs.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and safety of transcatheter arterial embolization of omental artery aneurysm: A single-center experience

Nozawa,

Ono,

Hasegawa

et al. 2024

Asian Cardiovasc Thorac Ann

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Background Omental artery aneurysm (OAA) is an extremely rare visceral artery aneurysm. Ruptured OAAs are associated with a high mortality rate. Transcatheter arterial embolization (TAE) has been used to treat OAA in recent years. However, the risk of omental ischemia due to TAE remains unclear. Therefore, this study aimed to investigate the efficacy and safety of TAE of OAA as a first-line treatment. Methods Fifteen patients with true aneurysms or pseudoaneurysms who underwent OAA-TAE between 1 April 2010 and 31 December 2022 were included in this study. The technical and clinical outcomes, the incidence of omental infarction after TAE as a major complication, OAA-TAE techniques, radiological findings on computed tomography angiography and angiogram, and patient characteristics were evaluated. Results Fifteen patients (nine men, six women; age, 69.8 ± 18.59 years) underwent TAE of OAAs (mean aneurysm size of 9.30 ± 6.10 mm) located in the right gastroepiploic ( n = 9), left gastroepiploic ( n = 1), and epiploic ( n = 5) arteries. All patients with ruptured ( n = 6) and unruptured ( n = 9) OAA successfully underwent TAEs using coils, n-butyl-2-cyanoacrylate, or gelatin sponges. Hepatic artery thrombosis and coil migration were observed during the procedure; however, these adverse events were manageable. Transfusion of red blood cell units (4.66 ± 1.63 units) was required only in cases with ruptured OAAs after TAE. Additional surgery or TAE due to rupture or rerupture of OAA and omental infarction was not required during the postoperative and follow-up periods. Conclusion The OAA-TAE can effectively treat ruptured and unruptured OAAs, and the risk of omental infarction after OAA-TAE may not be high.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of transcatheter arterial embolization of omental artery aneurysm: A single-center experience

Nozawa,

Ono,

Hasegawa

et al. 2024

Asian Cardiovasc Thorac Ann

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“…The clinical presentation is not specific, and most of the reported cases showed that the typical signs of idiopathic omental bleeding are atypical abdominal pain, nausea and vomiting, tachycardia, and hypotensive [ 5 , 16 ]. Ultrasonography (US), CT scanning, and paracentesis may all be useful to establish the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Spontaneous rupture of omental vessels could lead to a high mortality rate if it is associated with hemoperitoneum [4]. Most of the patients that are diagnosed with spontaneous rupture of the omental artery have been treated with transcatheter arterial embolization (TAE) or surgery [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Successful Conservative Management of Spontaneous Greater Omental Artery Aneurysm: A Case Report

Abdullah¹,

Khamseen²,

Alomran³

et al. 2023

Cureus

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Omental hemorrhage is the result of a rupture of the omental vessels. Many causes have been identified to cause omental hemorrhage, which includes trauma, aneurysms, vasculitis, and neoplasms. Spontaneous omental hemorrhage is rare, and usually, patients present with a vague clinical manifestation. In this article, we present the case of a 62-year-old male patient who presented to the emergency department complaining of severe epigastric pain. He was diagnosed by enhanced computed tomography as having a great omental aneurysm and admitted to the surgical ward. The patient was treated conservatively with no apparent complications. Physicians should be made aware of the possibility of great omental bleeding even if none of the mentioned risk factors have been recognized to prevent the life-threatening complications that would follow this condition.

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“…Omental hemorrhage commonly presents in male patients with abdominal pain and occasionally with nausea, vomiting, or diarrhea. However, some of our included cases may not have had any other abdominal symptoms [ 6 , 8 – 13 ].…”

Section: Discussionmentioning

confidence: 99%

Idiopathic omental hemorrhage: a case report and review of the literature

Rashidi,

Samimiat,

Jafarimehrabady

et al. 2023

J Med Case Reports

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Background A spontaneous rupture of an omental vessel can cause severe intraabdominal hemorrhage. We present a case of idiopathic omental hemorrhage caused by a vascular malformation. The literature is systematically reviewed. Case presentation A 65-year-old Iranian man was admitted to the emergency department for 10 days with abdominal pain. His medical history was not significant. Fever, vomiting, nausea, or anorexia were not reported. However, he was suffering from diaphoresis and malaise at the time. He did not smoke or drink alcohol. During physical examination, blood pressure was 82/60 mmHg with a temperature of 36.6 °C; heart rate was 96 beats/minute and respiratory rate was 18 breaths per/minute. An abdominal examination revealed mild tenderness in the periumblical. The focused assessment with sonography in trauma examination yielded positive results. The complete blood count showed 14 × 103/mcL of white blood cells and 185 × 103/mcL of platelets. The hemoglobin value was 6.7 g/L at admission. To stabilize the patient’s condition, a unit of packed cell was administered. A double contrast enhancement abdominal computer tomography was performed, which revealed a massive hemoperitoneum. Subsequently, an exploratory laparoscopy was performed to search for the responsible pathology. But it was not successful. The surgical plan was changed to laparotomy. The hemorrhage source was not found during laparotomy. Observation revealed a massive hemoperitoneum originating in the omental vessels. A portion of the omentum located on the greater omentum at the greater curve was removed. Based on the pathological examination of the extracted tissue, vascular malformations were identified. The patient recovered uneventfully and was discharged from the hospital 7 days after surgery. Previous reports assessing idiopathic omental bleeding were systematically reviewed. A total of 14 hits were identified in PubMed and Scopus from 2015 to November 2022 for idiopathic omental bleeding. Conclusion Presence of positive focused assessment with sonography in trauma, abdominal pain, imaging evidence of fluid accumulation, and a reduction in hemoglobin levels collectively indicate the likelihood of arteriovenous malformation occurrence. The treatment options include surgical intervention and transcatheter arterial embolization. Surgical intervention is recommended for subjects with hemodynamic instability, persistent hypotension and those whose diagnosis is unconfirmed.

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Spontaneous rupture of a left omental artery aneurysm treated by transcatheter arterial embolization: A case report

Cited by 4 publications

References 13 publications

Efficacy and safety of transcatheter arterial embolization of omental artery aneurysm: A single-center experience

Efficacy and safety of transcatheter arterial embolization of omental artery aneurysm: A single-center experience

Successful Conservative Management of Spontaneous Greater Omental Artery Aneurysm: A Case Report

Idiopathic omental hemorrhage: a case report and review of the literature

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