J Korean Soc Emerg Med.  2017 Aug;28(4):391-394. 10.0000/jksem.2017.28.4.391.

A Case of Rectus Sheath Hematoma with Spontaneous Inferior Epigastric Artery Injury Treated Successfully by Angioembolization

• Lee DE
• Ahn JY
• Moon S

• KMID: 2393984
• DOI: http://doi.org/10.0000/jksem.2017.28.4.391

Abstract

Rectus sheath hematoma with spontaneous inferior epigastric artery injury (IEAI) is rarely found and can often be mistaken for something else causing abdominal pain. We present the case of rectus sheath hematoma with spontaneous IEAI caused by coughing in a 61-year-old woman. She presented to our emergency department with a chief complaint of rightlower quadrant pain after severe coughing. An abdominal computed tomography scan with contrast enhancement demonstrated rectus sheath hematoma with active hemorrhage; angiography with selective embolization of the right inferior epigastric artery was performed successfully without complication. Even if a patient with nontraumatic abdominal pain had no anticoagulant therapy or coagulopathy, an abdominal contrast-enhanced computed tomography scan is essential for early diagnosis of spontaneous IEAI. Arteriography with selective embolization of the injured arteries is useful and highly effective in the control of ongoing hemorrhage owing to IEAI.

Keyword

Abdominal pain; Angiography; Epigastric arteries; Embolization; therapeutic; Rupture; Spontaneous

MeSH Terms

Abdominal Pain
Angiography
Arteries
Cough
Early Diagnosis
Emergency Service, Hospital
Epigastric Arteries*
Female
Hematoma*
Hemorrhage
Humans
Middle Aged
Rupture