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Spontaneous extraperitoneal lumbar artery hemorrhage
Salim Surani1, Barbara Estement, Subham Manchandan
1Texas A&M University, Corpus Christi, Texas, USA.
The Journal of Emergency Medicine
|October 17, 2008
Summary
Spontaneous extraperitoneal hemorrhage (SEH) is a rare complication of anticoagulation. Angiography with arterial embolization offers a safe, effective alternative to surgery for managing SEH, improving patient stability.
Area of Science:
- Interventional Radiology
- Emergency Medicine
- Vascular Surgery
Background:
- Spontaneous extraperitoneal hemorrhage (SEH) is an infrequent complication associated with anticoagulation therapy.
- Traditional management for refractory SEH involves surgical intervention.
- Angiography and arterial embolization present a viable alternative to surgery.
Observation:
- A 67-year-old male presented with hemodynamic collapse from retroperitoneal bleeding.
- Rupture of a lumbar artery was identified as the cause of bleeding.
- Emergency abdominal angiography revealed active bleeding from a lumbar vessel.
Findings:
- Catheter embolization and microcoil embolization successfully localized and treated the bleeding lumbar artery.
- The patient achieved hemodynamic stabilization without requiring surgical intervention.
- This interventional approach reduced the need for blood transfusions.
Implications:
- Prompt angiography and embolization can be a safe and effective treatment for spontaneous extraperitoneal hemorrhage.
- This minimally invasive technique offers an alternative to surgery, improving patient outcomes.
- Increased awareness among emergency physicians regarding embolization for SEH is crucial.
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