Abdominal Wall Hematoma After Laparoscopic Surgery: Early Treatment with Selective Arterial Transcatheter Embolization

Abstract

Bleeding from the site of a trocar insertion is a relatively frequent complication after laparoscopic surgery, despite precautionary techniques aimed at reducing such events. It may result in a hemoperitoneum, requiring emergency reintervention or large hematomas of the abdominal wall. In the latter case, although conservative treatment is possible, hospital stay is prolonged and large amounts of blood-bank resources are consumed. Early diagnosis and selective embolization of the bleeding vessel may reduce the severity and consequences of this complication.

Single‐port appendectomy in obese children: an optimal alternative?

“…Blind insertion of the ports during TPA can lead to injury of the abdominal wall vessels and haematoma formation (25,26). Blind insertion of the ports during TPA can lead to injury of the abdominal wall vessels and haematoma formation (25,26).…”

“…In obese children and adolescents, there is absence of trans-illumination of the abdominal wall for the identification of vessels during port insertion. Blind insertion of the ports during TPA can lead to injury of the abdominal wall vessels and haematoma formation (25,26). This may also lead to hemoperitoneum and add difficulties to the laparoscopic procedure.…”

Intra-abdominal and abdominal wall haematoma from 5 mm port insertion site in laparoscopic cholecystectomy.

“…Giant parietal wall haematoma after laparoscopic appendectomy [6] or right hemicolectomy [7] or pelvic pseudocyst removal [8], with probable inferior epigastric artery injury, has been reported previously. In these circumstances epigastric vessels are those most commonly injured [9].…”

“…Delayed bleeding in a stable patient may respond to conservative management [9]. Treatment with selective arterial transcatheter embolization is also reported [7]. An unstable patient needs emergent wound exploration or formal laparotomy [6].…”

Gynäkologisch-geburtshilfliche Notfälle − Komplikationen bei endoskopischen Eingriffen

“…Eine arterielle Gefäßverlet-zung kann durchaus zur Ausbildung von größeren, revisionspflichtigen Hämato-men führen; es sind sogar einzelne Verläufe von transfusionspflichtigen Blutungen beschrieben [28]. Prinzipiell ist bei der An lage der Arbeitstrokare auf die obligate Diaphanoskopie zu achten, die es in der Regel möglich macht, größere epigastrische Gefäßverläufe zu meiden.…”