Korean J Gastroenterol.  2015 Mar;65(3):186-189. 10.4166/kjg.2015.65.3.186.

A Case of Spontaneous Bleeding of Multiple Lumbar Arteries in a Patient with Liver Cirrhosis

• Hong JS
• Jeong WJ
• Han YH
• Shin SY
• Jun JH
• Woo YM
• Yun JH
• Cheon GJ

• KMID: 2373206
• DOI: http://doi.org/10.4166/kjg.2015.65.3.186

Abstract

Esophageal and gastric varix, portal hypertensive gastropathy, Mallory-Weiss tear and gastric ulcer are common causes of bleeding in patients with liver cirrhosis. However, spontaneous arterial bleeding without a history of trauma is a rare cause of bleeding which can be fatal. We report a case of a 55-year-old woman with alcoholic liver cirrhosis who developed spontaneous bleeding of multiple right lumbar arteries and died in spite of repetitive transfusion and embolization.

Keyword

Spontaneous arterial bleeding; Liver cirrhosis; Lumbar artery

MeSH Terms

Arteries
Female
Gastrointestinal Hemorrhage/*etiology/therapy
Hematoma/diagnosis
Humans
Liver Cirrhosis/complications/*diagnosis
Lung Injury/pathology
Middle Aged
Tomography, X-Ray Computed

Figure

• 

  Fig. 1. Initial multidetector CT. Axial CT arterial phase images show hematoma (arrows) in the right retroperitoneal space without active extravasation of contrast material.

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  Fig. 2. CT angiography. Axial CT shows nodular and linear high attenuation that is iso-attenuating relative to the inferior vena cava. This lesion corresponds to active extravasation of contrast material (arrow) and shows increased retroperitoneal hematoma compared with initial multidetector CT.

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  Fig. 3. Conventional angiography. (A) Conventional angiogram shows active extravasation of contrast material (arrow) from right lumbar arteries (L2). (B) Conventional angiogram of right L2-L4 lumbar arteries, obtained after selective coil embolization of the actively bleeding artery, shows that active arterial extravasation has been resolved.

Reference

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