Severe Intraperitoneal Hemorrhage from Pseudoaneurysm after a Large-volume Paracentesis, Successfully Treated with Microcoil Embolization.
10.4166/kjg.2018.71.3.162
- Author:
Soo Hyung RYU
1
;
Dong Il KWON
Author Information
1. Division of Gastroenterology, Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea. rshdrryu@hanmail.net
- Publication Type:Case Report
- Keywords:
Paracentesis;
Pseudoaneurysm;
Hemorrhage;
Liver cirrhosis;
Angiography
- MeSH:
Aneurysm, False*;
Angiography;
Ascites;
Ascitic Fluid;
Contrast Media;
Dyspnea;
Embolization, Therapeutic;
Epigastric Arteries;
Extravasation of Diagnostic and Therapeutic Materials;
Hemorrhage*;
Humans;
Hypotension;
Iliac Artery;
Liver Cirrhosis;
Liver Cirrhosis, Alcoholic;
Middle Aged;
Paracentesis*;
Peritoneal Cavity
- From:The Korean Journal of Gastroenterology
2018;71(3):162-167
- CountryRepublic of Korea
- Language:English
-
Abstract:
Large-volume paracentesis-induced intraperitoneal hemorrhage due to pseudoaneurysm formation is rarely reported. Here, we present a 56-year-old man with alcoholic liver cirrhosis admitted for massive ascites. Large-volume paracentesis was performed. Three days later, he became pale and complained of dyspnea and abdominal distention with hypotension. Percutaneous iliac angiography revealed contrast media leakage from a branch of the left circumflex iliac artery with pseudoaneurysm. He was successfully treated with microcoil embolization. Several days later, ascitic fluid increased and large-volume paracentesis was performed again. Two days later, his hemoglobin level suddenly decreased. An abdominal computed tomography scan showed new active bleeding at the left lower lateral peritoneal cavity, just anterior to the metalic coils. Percutaneous iliac angiography revealed contrast media extravasation from a branch of the left inferior epigastric artery with formation of collateral vessel. Percutaneous embolization was successfully performed again. After coil embolization, there were no further bleeding episodes.
