Korean J Obstet Gynecol.  2012 Jun;55(6):441-444. 10.5468/KJOG.2012.55.6.441.

A case of retroperitoneal hematoma caused by left ovarian artery rupture following mild blunt trauma

• Kang JY
• Han MS
• Choi IJ
• Ann HS
• Cha MS

• KMID: 1783941
• DOI: http://doi.org/10.5468/KJOG.2012.55.6.441

Abstract

Rupture of the ovarian artery is a rare but life-threatening injury and most often associated with pregnancy. It is hard to find a case of ovarian artery rupture associated with blunt trauma. We report a case of retroperitoneal hematoma caused by rupture of left ovarian artery occurred after abdominal blunt trauma including brief review of the literatures.

Keyword

Ovarian artery rupture; Blunt trauma

MeSH Terms

Arteries
Hematoma
Pregnancy
Rupture

Figure

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  Fig. 1 Abdominal computed tomography scan on the 2nd day after trauma. It shows retroperitoneal hematoma in left anterior pararenal space (arrow). The contrast media in not estravasated to left retroperitoneal hematoma.

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  Fig. 2 Computed tomography (CT) angiography on the 8th day after trauma. There was aggravated left retroperitoneal hematoma (circles) than previous CT scan. There was extravasation of contrast media around left ovarian artery (arrow).

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  Fig. 3 Abdominal pelvic computed tomography scan on the 8th day after operation. It shows decreased size of retroperitoneal hematoma in left anterior pararenal space (circles). The contrast media is not estravasated to left retroperitoneal hematoma.

Reference

1. Asensio JA, Forno W, Roldan G, Petrone P, Rojo E, Ceballos J, et al. Visceral vascular injuries. Surg Clin North Am. 2002. 82:1–20.

2. Paulus C, Citak M, Durnwalder O, Herzog R, Diener U. Two-stage traumatic rupture of the arteria ovarica after high energy trauma. Z Orthop Unfall. 2011. 149:424–427.

3. Guillem P, Bondue X, Chambon JP, Lemaitre L, Bounoua F. Spontaneous retroperitoneal hematoma from rupture of an aneurysm of the ovarian artery following delivery. Ann Vasc Surg. 1999. 13:445–448.

4. Ekbom GA, Towne JB, Majewski JT, Woods JH. Intra-abdominal vascular trauma-a need for prompt operation. J Trauma. 1981. 21:1040–1044.

5. Henao F, Aldrete JS. Retroperitoneal hematomas of traumatic origin. Surg Gynecol Obstet. 1985. 161:106–116.

6. Chan YC, Morales JP, Reidy JF, Taylor PR. Management of spontaneous and iatrogenic retroperitoneal haemorrhage: conservative management, endovascular intervention or open surgery? Int J Clin Pract. 2008. 62:1604–1613.

7. Feliciano DV. Management of traumatic retroperitoneal hematoma. Ann Surg. 1990. 211:109–123.

8. Goins WA, Rodriguez A, Lewis J, Brathwaite CE, James E. Retroperitoneal hematoma after blunt trauma. Surg Gynecol Obstet. 1992. 174:281–290.

9. Jung SI, Whang CW. Traumatic retroperitoneal hematoma. J Korean Surg Soc. 1993. 44:572–578.

10. Chu YS, Kim OJ, Choi SU, Lee JH. Usefulness of FAST for evaluation of blunt abdominal trauma patients. J Korean Soc Traumatol. 2006. 19:135–142.

11. Yoon JY, Kim SH, Ahn R, Hwang JC, Hong ES. Comparison of intraperitoneal and retroperitoneal/pelvic contrast extravasation: the characteristics and prognosis of the each patient group with arterial embolization according to the abdominal computed tomography scanning after blunt trauma. J Korean Soc Traumatol. 2009. 22:199–205.

12. Bageacu S, Kaczmarek D, Porcheron J. Management of traumatic retroperitoneal hematoma. J Chir (Paris). 2004. 141:243–249.

13. Daly KP, Ho CP, Persson DL, Gay SB. Traumatic Retroperitoneal Injuries: Review of Multidetector CT Findings. Radiographics. 2008. 28:1571–1590.