Abdominal Apoplexy Due to Spontaneous Rupture of an Aberrant Accessory Hepatic Artery

Perea, Anna; Tinsley, Ellis A.; Mason, Lockert B.

doi:10.1097/00007611-198202000-00031

Cited by 6 publications

(4 citation statements)

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“…The latent phase may last from hours to days, and patients may be devoid of symptoms. It is during the terminal phase that the patient's condition rapidly deteriorates with the onset of hypovolemic shock (9). The constellation of symptoms that may help in the diagnosis of ISIH includes sudden onset of severe abdominal pain, distension, and signs of generalized peritoneal irritation associated with unexplained hypotension (10).…”

Section: Discussionmentioning

confidence: 99%

Abdominal apoplexy: rupture of short gastric artery after retching

Ambikapathi¹,

Subramaniam²,

Hayati³

2022

Ann Afr Surg.

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Abdominal apoplexy, or idiopathic spontaneous intraperitoneal hemorrhage (ISIH), is a rare but often fatal condition resulting from a variety of disease processes affecting abdominal vasculature. A 30-year-old woman presented with acute abdominal pain and breathlessness and was in class II hypovolemic shock. She had a history of multiple episodes of retching with non-bilious vomiting prior to that. Computed tomography (CT) reported a non-rotation of the gut, gross intraperitoneal free fluid with debris, and possible perforated appendicitis. Laparoscopy revealed a gross hemoperitoneum of 2.5 L, with bowel findings consistent with non-rotation of the gut, but technical difficulty in identifying the source of bleeding led to conversion to laparotomy. A ruptured short gastric artery was ascertained to be the source of bleeding and was successfully ligated. A retrospective review of the preoperative CT showed intraperitoneal free fluid with Hounsfield unit measurements of 48 and 52, suggestive of acute hemoperitoneum. ISIH is often a delayed diagnosis or missed diagnosis due to its low incidence. The presence of vomiting and abdominal pain with hypovolemic shock, especially in a young individual, should raise the suspicion of ISIH, which can be confirmed via early CT imaging to facilitate achieving hemostasis during surgery.

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Section: Discussionmentioning

confidence: 99%

Abdominal apoplexy: rupture of short gastric artery after retching

Ambikapathi¹,

Subramaniam²,

Hayati³

2022

Ann Afr Surg.

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“…The symptoms of haemoperitoneum may be divided into three phases [19]. There is an initial phase of mild to severe abdominal pain.…”

Section: Discussionmentioning

confidence: 99%

A case of abdominal apoplexy because of the rupture of the short gastric vessel

Osunkunle

Al-Shoek

2015

Journal of Surgical Case Reports

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Abdominal apoplexy or idiopathic spontaneous intraperitoneal haemorrhage is defined as the presence of free blood within the peritoneal cavity. Non-traumatic and non-iatrogenic causes may cause abdominal apoplexy. It has a variable clinical presentation, with abdominal pain being an early and non-specific symptom. We report a rare case of a 23-year-old male with abdominal apoplexy because of rupture of the short gastric artery. He presented to our department with abdominal pain. Later, he developed signs of shock, and was found to have haemoperitoneum on laparotomy. We ligated the short gastric artery, which was the bleeding source, and he had an uneventful postoperative course. We also review the literature on existing cases of short gastric vessel rupture.

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“…In 1937, Bruce proposed that abdominal apoplexy in young patients might be due to rupture of a mesenteric artery as a result of a structural defect in the vessel wall. 1 Since then, the literature contains many reports [1][2][3]10,11 attributing an uncharacterized vessel wall abnormality as the cause of abdominal apoplexy in young persons. Although arteriosclerosis and hypertension are potential predisposing factors in older patients, they cannot be incriminated as a cause in young healthy patients.…”

Section: Discussionmentioning

confidence: 99%

“…This morbid event is characterized by acute onset of abdominal pain, followed by either immediate or delayed hemodynamic collapse. [1][2][3] Nearly all splanchnic arteries have been implicated as the cause of this catastrophic event, although in as many as one fourth of cases no specific source of hemorrhage is ever identified. 2 We report a case of abdominal apoplexy due to rupture of an ileocolic artery aneurysm in a patient with Ehlers-Danlos syndrome (EDS) type IV and a novel mutation of the type III procollagen gene COL3A1.…”

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confidence: 99%

Ehlers-Danlos Syndrome Type IV and a Novel Mutation of the Type III Procollagen Gene as a Cause of Abdominal Apoplexy

Hassan¹,

Rasmussen

Schwarze

et al. 2002

Mayo Clinic Proceedings

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Abdominal apoplexy is a clinical entity characterized by spontaneous intraperitoneal hemorrhage from rupture of a visceral vessel. We describe a 34-year-old man who presented with abdominal apoplexy due to rupture of an ileocolic aneurysm. Subsequent biochemical and genetic analysis confirmed the diagnosis of Ehlers-Danlos syndrome type IV based on abnormal production of type III procollagen and a novel mutation in the COL3A1 gene. Patients presenting with abdominal apoplexy should undergo a thorough examination so that the underlying vascular pathology can be identified.

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Abdominal Apoplexy Due to Spontaneous Rupture of an Aberrant Accessory Hepatic Artery

Cited by 6 publications

References 0 publications

Abdominal apoplexy: rupture of short gastric artery after retching

Abdominal apoplexy: rupture of short gastric artery after retching

A case of abdominal apoplexy because of the rupture of the short gastric vessel

Ehlers-Danlos Syndrome Type IV and a Novel Mutation of the Type III Procollagen Gene as a Cause of Abdominal Apoplexy

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