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Chronic epigastric blood collection after coronary artery bypass grafting: case report
Alberto Aliprandi1, Alfonso Fausto, Eugenio Mossuto
1Department Of Diagnostic Imaging, Istituto Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy.
Insights
A patient experienced epigastric pain post-coronary artery bypass grafting. Imaging revealed a chronic hematoma, correctly identified by its distinct fluid levels and feeding vessel, aiding diagnosis.
Area of Science:
- Gastroenterology
- Cardiovascular Surgery
- Radiology
Background:
- Post-coronary artery bypass grafting (CABG) complications can manifest with diverse symptoms.
- Epigastric pain is a potential, though less common, post-CABG presentation.
Observation:
- A clinical case involving a patient presenting with epigastric pain three months after undergoing CABG.
- Computed tomography (CT) demonstrated an abdominal mass characterized by a thick wall and an internal horizontal fluid level.
Findings:
- The CT findings were indicative of a chronic hematoma with clear separation of blood components (serum and formed elements).
- Linear contrast enhancement at the interface of these components was identified as a feeding artery, confirming the hematoma's vascular supply.
Implications:
- Accurate interpretation of CT imaging is crucial for diagnosing post-CABG abdominal complications.
- Understanding the imaging characteristics of chronic hematomas, including their vascularity, aids in appropriate clinical management.
Abstract:
A clinical case of epigastric pain 3 months after coronary artery bypass grafting (CABG) is presented. The CT finding of an abdominal mass with thick wall, internal horizontal by-gravity level and linear contrast enhancement at the border between the two different components was correctly interpreted for a chronic hematoma with separation of the formed blood elements from blood serum; in particular, the linear contrast enhancement was related to an artery-feeding vessel.