Transcatheter Arterial Embolization for Spontaneous Rupture of the Omental Artery

Matsumoto, Tomohiro; Yamagami, Takuji; Morishita, Hiroyuki; Iida, Shigeharu; Tazoe, Jun; Asai, Shiho; Masui, Koji; Ikeda, Jun; Nagata, Akihiro; Sato, Osamu

doi:10.1007/s00270-010-9956-1

Cited by 29 publications

(42 citation statements)

References 9 publications

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“…The absence of an identifiable source of bleeding is not unusual. Literature suggests that in approximately a third of published ISIH cases, the source of bleeding was not identified on CT scan or even during exploratory laparotomy 8. In this instance, there was no source of bleeding identified despite a thorough investigation of all the abdominal viscera during exploratory surgery.…”

Section: Discussionmentioning

confidence: 83%

Idiopathic spontaneous lesser sac haematoma: a perplexing case of abdominal apoplexy

Cunha¹,

Narayanan

Marimuthu

et al. 2017

BMJ Case Reports

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A 37-year-old woman presented with a 3-hour history of back pain, nausea and vomiting and an episode of syncope. A fluid collection in the lesser sac was detected on ultrasound and CT scan. Emergency laparoscopy and subsequent laparotomy were performed and a large blood clot was evacuated from the lesser sac. No identifiable source or predisposition to bleeding was found. She made a full recovery postoperatively. There are few reported cases of spontaneous intraperitoneal haemorrhage. In a third of cases, there is no identifiable source of bleeding. Unfortunately, patients present late with non-specific symptoms and a prompt diagnosis is difficult to make. The case reiterates the importance of awareness of lesser sac haematoma formation; an unusual clinical entity with a high morbidity and mortality rate. A high index of suspicion, radiological adjuncts and appropriate surgical intervention, especially in unstable patients, is essential for a good outcome.

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Section: Discussionmentioning

confidence: 83%

Idiopathic spontaneous lesser sac haematoma: a perplexing case of abdominal apoplexy

Cunha¹,

Narayanan

Marimuthu

et al. 2017

BMJ Case Reports

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“…Several causes of omental bleeding are known, including injury and irritation from trauma, neoplasia [2], arterial aneurysm rupture [3], and anticoagulant therapy [4]. However, it rarely develops spontaneously [5–7]. In our case, there was no episode of abdominal trauma or bleeding disorders and no appreciable familial or medical history.…”

Section: Discussionmentioning

confidence: 80%

“…However, there have been few reports on TAE for spontaneous rupture of the omental artery, including only one case reported in English and three cases in Japanese [7–10]. No cases were associated with triggers such as bleeding factors or injury.…”

Section: Discussionmentioning

confidence: 99%

“…However, it rarely develops without any specific triggers [5, 6]. We found only four reports on transcatheter arterial embolization (TAE) for rupture of the omental artery [7–10]. Along with a review of these reports, we herein present a case of omental artery rupture treated by TAE in a young patient who had no history of a related disease or trauma.…”

Section: Introductionmentioning

confidence: 99%

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Spontaneous Rupture of the Omental Artery Treated by Transcatheter Arterial Embolization

Takahashi

Matsuoka

Yasutake

et al. 2012

Case Reports in Radiology

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Intra-abdominal hemorrhage caused by omental artery rupture is a rare condition. There are few reports on the treatment of omental artery rupture with only transcatheter arterial embolization (TAE). A 27-year-old man presented to our emergency room with upper abdominal pain that suddenly occurred during sleep. Abdominal computed tomography (CT) revealed fluid collection in the peritoneal cavity and a left subphrenic hematoma with extravasation. Celiac angiography revealed extravasation from the omental artery, which arose from the proximal left gastroepiploic artery. A microcatheter was advanced into the left gastroepiploic artery and around the culprit artery bifurcation, which was embolized by inserting coils. The postoperative course was uneventful without worsening of anemia or abdominal symptoms. The patient was discharged after the absence of extravasation was confirmed by contrast-enhanced CT. Although surgical therapy has often been performed for omental bleeding, TAE, which is less invasive and has the advantage of simultaneous diagnosis and treatment, should be attempted as the first-choice therapy.

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“…Omental bleeding has also been associated with varices (3), hemangiopericytomas, leiomyoblastomas, omental torsion (2), aneurysms (4), and an aneurysm in a peritoneal dialysis patient (5), none of which were identified in the described patient. Generalized pathologic conditions associated with spontaneous bleeding have included segmental arterial mediolysis (segmental mediolytic arteritis), systemic lupus erythematosus, Ehlers-Danlos syndrome type IV (9), fibromuscular dysplasia (9), hypertension, polycythemia vera, and Wegener’s granulomatosis (6). …”

Section: Discussionmentioning

confidence: 99%

Idiopathic omental bleeding

Henry

Satgunam

2012

Journal of Surgical Case Reports

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Omental bleeding without any evidence of trauma, aneurysms, or other pathology has been rarely described in the literature. We report a case of a 24 year-old female on aspirin/acetaminophen/caffeine for migraines who presented with abdominal pain and tachycardia. Computed tomography angiography revealed active extravasation in the right lower quadrant. During exploratory laparotomy, a small bleeding artery within the greater omentum was suture ligated, and two liters of fresh and clotted blood were evacuated. The patient recovered successfully. We review the diagnosis and management of this rare condition.

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Transcatheter Arterial Embolization for Spontaneous Rupture of the Omental Artery

Cited by 29 publications

References 9 publications

Idiopathic spontaneous lesser sac haematoma: a perplexing case of abdominal apoplexy

Idiopathic spontaneous lesser sac haematoma: a perplexing case of abdominal apoplexy

Spontaneous Rupture of the Omental Artery Treated by Transcatheter Arterial Embolization

Idiopathic omental bleeding

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