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J Korean Soc Emerg Med > Volume 28(4); 2017 > Article
Journal of The Korean Society of Emergency Medicine 2017;28(4): 391-394.
A Case of Rectus Sheath Hematoma with Spontaneous Inferior Epigastric Artery Injury Treated Successfully by Angioembolization
Dong Eun Lee, Jae Yun Ahn, Sungbae Moon
Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
Correspondence  Jae Yun Ahn ,Tel: 053-200-6400, Fax: 053-428-2820, Email: jyahn@knu.ac.kr,
Received: June 1, 2017; Revised: June 5, 2017   Accepted: June 30, 2017.  Published online: August 31, 2017.
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.
Key words: Abdominal pain, Angiography, Epigastric arteries, Embolization, therapeutic, Rupture, Spontaneous
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