Angiography-assisted computed tomography for the detection and intervention of a subtle aneurysm of the omentum.
Intra-abdominal hemorrhage caused by omental artery rupture is a rare condition traditionally diagnosed via exploratory laparotomy in hemodynamically unstable patients. We experienced a case in which contrast-enhanced multidetector computed tomography (MDCT) and digital subtraction angiography did not identify the rupture site, whereas CT during left omental arteriography depicted a small 4-mm aneurysm. The lesion was then embolized with microcoils and N-butyl cyanoacrylate lipiodol glue. We consider that performing a CT during selective arteriography could be useful in cases in which the rupture site is unclear with other imaging techniques such as contrast-enhanced MDCT and digital subtraction angiography.
Center for Minimally Invasive Treatment, Nippon Medical School Musashikosugi Hospital, 1-396 Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa, 211-8533, Japan, h-tajima@nms.ac.jp.
Hiroyuki
H
Tajima
Shiro
S
Onozawa
Saiko
S
Isshiki
Naoko
N
Takenoshita
Tadashi
T
Kaneshiro
Taro
T
Ichikawa
Satoru
S
Murata
Kiyoshi
K
Matsuda
Akira
A
Furukawa
D017542:Aneurysm, Ruptured / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D015901:Angiography, Digital Subtraction / Q000379:methods*; D003287:Contrast Media; D003937:Diagnosis, Differential; D004621:Embolization, Therapeutic / Q000379:methods*; D004659:Enbucrilate / Q000627:therapeutic use; D004998:Ethiodized Oil / Q000627:therapeutic use; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy; D006801:Humans; D007472:Iohexol; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D009852:Omentum / Q000098:blood supply / Q000000981:diagnostic imaging*; D011856:Radiographic Image Enhancement / Q000379:methods; D016896:Treatment Outcome
D003287:Contrast Media; D007472:Iohexol; D004998:Ethiodized Oil; D004659:Enbucrilate