A Rare Cause of Spontaneous Retroperitoneal Hematoma: The Rupture of the Adrenal Artery Aneurysm and its Endovascular Tr
- PDF / 452,050 Bytes
- 3 Pages / 595.276 x 790.866 pts Page_size
- 24 Downloads / 171 Views
CASE REPORT
A Rare Cause of Spontaneous Retroperitoneal Hematoma: The Rupture of the Adrenal Artery Aneurysm and its Endovascular Treatment Mehmet Beyazal 1
&
Oğuzhan Aziz Torlak 2
Received: 31 October 2019 / Accepted: 27 March 2020 # Association of Surgeons of India 2020
Abstract Adrenal artery aneurysm and its spontaneous rupture is a very scarce but severe condition that can require urgent treatment. A 79year-old man with retroperitoneal hemorrhage resulted from adrenal artery aneurysm who underwent endovascular treatment is reported in this case report. This case demonstrates the value of the selective angiography and endovascular treatment in the management of retroperitoneal hematoma due to rupture of visceral aneurysms. Keywords Spontaneous retroperitoneal hematoma . Adrenal artery aneurysm . Rupture . Endovascular treatment
Introduction Adrenal artery aneurysm and its spontaneous rupture is a rare cause of retroperitoneal hemorrhage. Early diagnosis and treatment is important in these entities because of their high mortality rate [1, 2]. We report a 79-year-old man with retroperitoneal hemorrhage resulted from adrenal artery aneurysm who underwent endovascular treatment.
Case Report A 79-year-old man presented to the emergency department with sudden onset left hypochondrial pain, which radiated to his back. The initial blood pressure of patient was 135/ 90 mmHg and heart rate was 117 beats per minute. There was no history of trauma. The patient’s laboratory examination disclosed white blood cell count of 19,300/mm3, platelet count of 230.000/mm3, and hemoglobin of 11 g/dL, hematocrit of 37.0%. Coagulation tests and urine analysis were * Mehmet Beyazal [email protected] 1
Department of Radiology, School of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
2
Department of General Surgery, Rize State Hospital, Rize, Turkey
normal. The routine contrast-enhanced abdominal computed tomography (CT) revealed a large left retroperitoneal hematoma. The contrast extravasation consistent with active bleeding was observed in the hematoma (Fig. 1). Due to active bleeding and hematoma, the patient was immediately taken to the interventional radiology suite. An urgent angiogram performed using right common femoral arterial approach. Selective arteriography of the left renal artery and superselective angiography of the left inferior suprarenal artery revealed a giant lobulated inferior suprarenal artery aneurysm. No active bleeding was detected at the time of the angiogram (Fig. 2a, b). Using a 2.8 Fr coaxial catheter system (Progreat, Terumo, Tokyo, Japan) the aneurysm sac was catheterized. Then, the aneurysm sac was embolized using a fibered platinum complex (0.018 in., 11 mm × 26 cm) coil (Fig. 2c, d). The patient’s condition was stabilized and symptoms subsequently resolved completely. The patient was discharged 3 days after the interventional procedure. The patient was symptom free at 12month follow-up.
Discussion Spontaneous retroperitoneal hematoma (SRH) is a potentially fatal and difficult-to-d
Data Loading...
