Spontaneous rectus muscle hematoma from inferior epigastric artery hemorrhage

• Serghei Covantsev ^{[1] [4]} ; Natalia Pichugina ^{[2] [4]} ; Andrei A. Kolotilshchikov ^{[1] [4]} ; Anna S. Sukhotko ^[3] ; Anna Bumbu ^[4] ; Maria Kantarovskaya ^[5]
  1. [1] Clinical Research and Development Department, Moscow, Russia
  2. [2] Department of Medical Ultrasonography, Botkin Hospital, Moscow, Russia
  3. [3] Department of Oncology, Nº 71, Botkin Hospital, Moscow, Russia
  4. [4] Department of Emergency Surgery Nº 76, Botkin Hospital, Moscow, Russia
  5. [5] Department of General Medicine, Patrice Lumumba Peoples’ Friendship University of Russia, Moscow, Russia

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• Localización: Academic Journal of Health Sciences: Medicina Balear, ISSN-e 2255-0560, Vol. 39, Nº. 4, 2024, págs. 157-160
• Idioma: inglés
• DOI: 10.3306/AJHS.2024.39.04.157
• Títulos paralelos:
  • Hematoma espontáneo del músculo recto por hemorragia de la arteria epigástrica inferior
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  • Texto completo (pdf)
• Resumen
  • español

    Es importante tener en cuenta las arterias epigástricas durante varios procedimientos quirúrgicos, como la colocación de trocares en cirugías laparoscópicas, la reparación de hernias inguinales, la paracentesis y la colocación de drenajes. La hemorragia de la arteria epigástrica inferior puede dar lugar a hematomas de la pared abdominal que pueden requerir cirugía. Aunque el traumatismo es la causa más frecuente de hemorragia de la arteria epigástrica inferior, se han dado varios casos de rotura espontánea de una arteria epigástrica inferior. Los factores predisponentes pueden incluir anticoagulación, enfermedad hematológica, operación abdominal previa, inyección de fármacos y aumento de la presión intraabdominal o embarazo. La ultrasonografía y la tomografia axial computarizada con realce intravenoso son los mejores métodos diagnósticos en un paciente hemodinámicamente estable. El tratamiento puede incluir cirugía, embolización endovascular o, en casos selectivos, tratamiento conservador. Presentamos un caso de hemorragia espontánea de la arteria epigástrica inferior que requirió cirugía y ligadura del vaso sangrante.

  • English

    The epigastric arteries are important to consider during several surgical procedures such as trocar placement in laparoscopic surgeries, inguinal hernia repair, paracentesis and drain placements. Bleeding from inferior epigastric artery may result in abdominal wall hematomas that may require surgery. Although trauma is the most common cause for inferior epigastric artery bleeding there have been several cases of spontaneous rupture of an inferior epigastric artery. Predisposing factors may include anticoagulation, hematological disease, previous abdominal operation, injection of drugs and increased intra-abdominal pressure or pregnancy. Ultrasonography (USG) and computed axial tomography with intravenous enhancement is the best diagnostic methods in a hemodynamically stable patient. The treatment can include surgery, endovascular embolization or in selective cases conservative management. We present a case of spontaneous inferior epigastric artery bleeding that required surgery and ligation of the bleeding vessel.

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