Korean J Hepatol.  2011 Sep;17(3):233-237. 10.3350/kjhep.2011.17.3.233.

Transcatheter coil embolization of the inferior epigastric artery in a huge abdominal wall hematoma caused by paracentesis in a patient with liver cirrhosis

• Park YJ
• Lee SY
• Kim SH
• Kim IH
• Kim SW
• Lee SO

• KMID: 1025205
• DOI: http://doi.org/10.3350/kjhep.2011.17.3.233

Abstract

Therapeutic paracentesis is considered to be a relatively safe procedure and is performed commonly for the control of massive ascites in patients with liver cirrhosis. The commonest puncture site, approximately 4 or 5 cm medial of left anterior superior iliac spine, can be located across the route of the inferior epigastric artery, which is one of the sites of potential massive bleeding. In a 46-year-old woman with liver cirrhosis and refractory ascites, a huge abdominal wall hematoma developed after therapeutic paracentesis. The patient was not stabilized by conservative treatment, and inferior epigastric artery injury was confirmed on angiography. Angiographic coil embolization of the inferior epigastric artery was conducted, after which the bleeding ceased and the hematoma stopped growing. This case indicates that physicians performing paracentesis should be aware of the possibility of inferior epigastric artery injury and consider early angiographic coil embolization when a life-threatening abdominal wall hematoma develops.

Keyword

Paracentesis; Hematoma; Inferior epigastric artery; Embolization

MeSH Terms

Abdominal Wall
Angiography
Ascites/surgery
Embolization, Therapeutic
Epigastric Arteries/*injuries
Female
Hematoma/*etiology/radiography/therapy
Humans
Liver Cirrhosis/*diagnosis
Middle Aged
Paracentesis/*adverse effects
Tomography, X-Ray Computed
Wounds, Nonpenetrating/complications