Spontaneous retroperitoneal hemorrhage caused by rupture of an ovarian artery aneurysm: A case report and review of the literature

Masafumi Toyoshima, Takako Kudo, Saori Igeta, Hiromitsu Makino, Yuta Momono, Takashi Shima, Rui Matsuura, Nobuko Ishigaki, Kozo Akagi, Yoichi Takeyama, Hideki Iwahashi, Hiroya Rikimaru, Akihiro Sato, Kosuke Yoshinaga

Research output: Contribution to journalReview articlepeer-review

8 Citations (Scopus)

Abstract

Introduction: Spontaneous rupture of an ovarian artery aneurysm is extremely rare. Although a majority of these cases have been associated with pregnancy, there have been recent reports and reviews of rare cases that were not directly associated with pregnancy. Transcatheter arterial embolization is considered to be an alternative therapy to surgery. Case presentation: A 44-year-old Japanese woman, gravida 3 para 3, presented to our emergency room complaining of intermittent right flank pain. She had undergone a cesarean section 2 years previously, and had no history of abdominal trauma. On admission, her blood pressure was 115/78 mmHg, pulse 70 beats per minute, and hemoglobin concentration 9.8 g/dL. Abdominal ultrasonography and contrast-enhanced dynamic computed tomography revealed a large retroperitoneal hematoma. Findings on three-dimensional computed tomography angiography suggested ruptured aneurysm of her right ovarian artery. A selective right ovarian artery angiogram revealed a tortuous aneurysm. Transcatheter arterial embolization using N-butyl-2-cyanoacrylate was performed. The aneurysm was successfully embolized, and her course after embolization was uneventful. She has remained symptom-free during 3 months of follow-up. Conclusions: This was a very rare case of a patient who had a retroperitoneal hemorrhage originating from an ovarian artery aneurysm. A review of published case reports found that contrast-enhanced computed tomography with reconstruction images is an excellent imaging tool. Diagnostic angiography and subsequent transcatheter arterial embolization are thought to be very effective for this condition.

Original languageEnglish
Article number84
JournalJournal of Medical Case Reports
Volume9
Issue number1
DOIs
Publication statusPublished - 2015 Apr 1

Keywords

  • Aneurysm
  • Multigravida
  • N-butyl-2-cyanoacrylate
  • Ovarian artery
  • Retroperitoneal hematoma
  • Spontaneous rupture
  • Transcatheter arterial embolization

ASJC Scopus subject areas

  • Medicine(all)

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