Korean J Gastroenterol.  2012 Feb;59(2):185-188. 10.4166/kjg.2012.59.2.185.

A Case of Lateral Abdominal Wall Hematoma Treated with Transcatheter Arterial Embolization

• Kang JW
• Kim YD
• Hong JS
• Kwon JH
• Seo HW
• Kim SH
• Lee JH
• Cheon GJ

• KMID: 1792825
• DOI: http://doi.org/10.4166/kjg.2012.59.2.185

Abstract

Paracentesis is a diagnostic, therapeutic procedure performed in patients with ascites. It is generally thought to be a safe procedure and transfusion of platelet concentrate or fresh frozen plasma is not recommended before the procedure, because the incidence of clinically significant bleeding is very low. We report a case of lateral abdominal wall hematoma due to the injury of the deep circumflex iliac artery after paracentesis in patient with alcoholic liver cirrhosis who was treated with transcatheter arterial embolization.

Keyword

Hematoma; Paracentesis; Therapeutic embolization; Liver cirrhosis

MeSH Terms

Abdominal Wall/*blood supply
Embolization, Therapeutic
Hematoma/etiology/*therapy
Humans
Iliac Artery/injuries
Liver Cirrhosis, Alcoholic/diagnosis
Male
Middle Aged
Paracentesis/adverse effects

Figure

• 

  Fig. 1 Abdominal CT. (A) Abdomen dynamic CT showed moderate amount of ascites, and small amount of hematoma in the left lower abdominal wall without evidence of focal lesion in the liver. (B) Follow-up abdomen dynamic CT showed a huge hematoma, which was more than 20 cm in size, on the lateral abdominal wall.

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  Fig. 2 Gross photograph. (A) Hematoma was noted on the paracentesis site. (B) Hematoma was expanding downwards to the thigh from the initial paracentesis site.

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  Fig. 3 Angiography. (A) Angiogram revealed leakage of contrast medium through the left deep circumflex iliac artery (arrow). (B) Transarterial embolization was done using gelfoam and coil (arrow).

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