title: Spontaneous hemoperitoneum due to rupture of the paraumbilical vein successfully treated with balloon-occluded retrograde transvenous obliteration.
abstract: Spontaneous hemoperitoneum is an uncommon condition, which may be critical even if treated appropriately. The paraumbilical vein is a portosystemic collateral vein that develops in patients with portal hypertension, and is rarely found to be a source of bleeding. Here we present a case report of spontaneous hemoperitoneum due to rupture of the paraumbilical vein successfully treated with balloon-occluded retrograde transvenous obliteration (B-RTO). A 69-year-old man with cirrhosis due to nonalcoholic steatohepatitis was admitted to our hospital with abdominal distention and pain. Computed tomography revealed hemoperitoneum with a dilated paraumbilical vein, and rupture of the paraumbilical vein was diagnosed to be the cause of anemia. B-RTO was performed via the left femoral vein with upstream embolization using microcoils, and thrombosis of the paraumbilical vein was confirmed after B-RTO. The patient was discharged without complications 20 days after B-RTO and he experienced no further episodes of bleeding during the subsequent 6-month period.
authors.affiliation: Department of Gastroenterology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo-ku, Sapporo, 060-0033, Japan. bossa0405@yahoo.co.jp.
authors.forename: Sho
authors.initials: S
authors.lastname: Kitagawa
authors.affiliation: Department of Gastroenterology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo-ku, Sapporo, 060-0033, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Sato
authors.affiliation: Department of Gastroenterology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo-ku, Sapporo, 060-0033, Japan.
authors.forename: Katsu
authors.initials: K
authors.lastname: Yamazaki
authors.affiliation: Department of Gastroenterology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo-ku, Sapporo, 060-0033, Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Ohmura
authors.affiliation: Department of Gastroenterology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo-ku, Sapporo, 060-0033, Japan.
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Karino
authors.affiliation: Department of Gastroenterology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo-ku, Sapporo, 060-0033, Japan.
authors.forename: Jouji
authors.initials: J
authors.lastname: Toyota
authors.affiliation: Department of Radiology, Sapporo Kosei General Hospital, Sapporo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Hasegawa
authors.affiliation: Department of Radiology, Sapporo Kosei General Hospital, Sapporo, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Sakai
authors.affiliation: Department of Radiology, Sapporo Kosei General Hospital, Sapporo, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Morita
keywords: Balloon-occluded retrograde transvenous obliteration; Intraperitoneal varices; Portal hypertension; Ruptured paraumbilical vein; Spontaneous hemoperitoneum