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26 August 2020: Articles

Post-Traumatic Retroperitoneal Hematoma Caused by Superior Rectal Artery Pseudoaneurysm

Challenging differential diagnosis, Unusual or unexpected effect of treatment, Rare disease

Karleigh R. Curfman A* , Mieka P. Shuman A , Kimberly M. Gorman A , Wesley B. Schrock A , Paul G. Meade A

DOI: 10.12659/AJCR.924529

Am J Case Rep 2020; 21:e924529

Table 1. Summary of reported cases of superior rectal artery pseudoaneurysm and summary of additional rare locations of pseudoaneurysms.

Presenting symptomsMechanism of injuryTreatment modalityTime to treatment
Abdominal pain, GI bleedFall while on anticoagulationAngiographic coil embolization of SRA4 weeks from initial presentation; 8 hours from re-presentation
GI bleedPenetrating perineal woundHartmann’s procedure, emergent Hartmann’s revision, subsequent angiographyPTD 0, PTD 3, PTD 19
With Gelfoam embolization of inferior mesenteric artery, anterior branch of
Bilateral internal iliac arteries
GI bleedPenetrating perineal woundCeliotomy with sigmoid loop colostomy; angiography withPTD 11, PTD 17
N-butyl cyanoacrylate (NBCA) embolization of SRA
GI bleedEndoscopic polypectomyAngiographic glue embolization of SRA10 days after polypectomy
GI bleedAntiplatelet useAngiographic coil embolization of SRA10 days after symptom onset
Abdominal painRenovascular hypertension, fibrodysplasiaAngiographic coil embolization of SRA6 weeks after initial presentation
GI bleedTumor induced SRA ruptureAngiographic embolization1 day after symptom onset
GI bleedHistory of bevacizumab therapyAngiographic coil embolization of SRANot reported
DrowsinessAcute head traumaCerebral angiogram with Histoacryl MMA embolizationNot reported
Headache, aphasiaHead traumaCerebral angiogram with glue MMA embolizationPTD 5 months
Abdominal painApixaban useEndovascular coilingImmediate
Recurrent bleedingHead traumaOpen surgical ligationPTD 4 weeks
Pain, swellingLacerationOpen surgical ligationPTD 3 weeks
Summary of documented case details to aid in comparison of cases and results, including presenting symptom, mechanism, treatment modality, and time to treatment [–,–]. SRA – superior rectal artery; GI – gastrointestinal, PTD – post-trauma day; MMA – middle meningeal artery.

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923