Treatment Of Laparoscopic Cholecystectomy Induced Pseudoaneurysm With Percutaneous Ultrasonography Guided Thrombin Injection

Year 2019, , 34 - 36, 01.01.2019

Mustafa Kaplan Mustafa Özdemir Muharrem Tola Volkan Gökbulut Muhammet Yener Akpınar

https://doi.org/10.5505/abantmedj.2019.94809

Abstract

62 years old female patient admitted to our clinic with abdominal pain 10 days after laparoscopic cholecystectomy. In tomography screening 9*2 cm sized lesion that primarily interpreted left rectus sheath hematoma was detected but relationship with vascular structures can not be identified. At doppler screening pseudoaneurysm sac that originated from inferior epigastric artery was seen in left rectus sheath hematoma localisation. Ultrasound-guided percutaneous thrombin injection was performed to this area. At control doppler ultrasonography, vascular filling disappeared. The fact that LK may be associated with pseudoaneurysms must be kept in mind, considering relatively easy radiological management.

Keywords

inferior epigastric artery, thrombin, rectus hematoma

Laparoskopik Kolesistektomi Sonrası Gelişen Psödoanevrizmanın Perkütan Ultrason Kılavuzluğunda Trombin İnjeksiyonu İle Başarılı Tedavisi: Olgu Sunumu

Abstract

62 yaşında bayan hasta laparoskopik kolesistektomi LK sonrası postoperatif 10. günde karın ağrısı gelişmesi üzerine kliniğimize başvurdu. Çekilen BT’de sol rektus kılıfı içerisinde öncelikle hematom lehine yorumlanan ancak vasküler yapı ile ilişkisi net değerlendirilemeyen 9x2 cm boyutunda lezyon izlendi. Dopler incelemede solda rektus kılıfı hematomu lokalizasyonunda inferior epigastrik arterden köken alan psödoanevrizma kesesi ile uyumlu görünüm izlendi. Bu alana US eşliğinde perkütan girilerek trombin enjeksiyonu yapıldı. Kontrol doplerinde kesede vasküler dolum izlenmedi. LK'nin psödoanevrizma ile ilişkili olabileceği ve radyolojik perkütan tedaviler ile başarılı bir şekilde tedavi edilebileceği akılda tutulmalıdır.

Keywords

inferior epigastrik arter, trombin, rektus hematomu

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