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Spontaneous retroperitoneal haemorrhage from pancreatoduodenal artery (PDA) rupture and associated complications

Spontaneous retroperitoneal haemorrhage (SRH) is rare. It may present with abdominal or back pain with or without haemodynamic instability. Aggressive resuscitation while investigating the cause of bleeding and providing haemostasis are the standard of care. Subsequent close monitoring is necessary...

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Autores principales: Tan, Edmund Wooi Keat, Shelat, Vishal G, Monteiro, Amelia Yuting, Low, Jee Keem
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9577903/
https://www.ncbi.nlm.nih.gov/pubmed/36253011
http://dx.doi.org/10.1136/bcr-2022-250383
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author Tan, Edmund Wooi Keat
Shelat, Vishal G
Monteiro, Amelia Yuting
Low, Jee Keem
author_facet Tan, Edmund Wooi Keat
Shelat, Vishal G
Monteiro, Amelia Yuting
Low, Jee Keem
author_sort Tan, Edmund Wooi Keat
collection PubMed
description Spontaneous retroperitoneal haemorrhage (SRH) is rare. It may present with abdominal or back pain with or without haemodynamic instability. Aggressive resuscitation while investigating the cause of bleeding and providing haemostasis are the standard of care. Subsequent close monitoring is necessary to identify early complications. This study reports three patients who presented to our institution within the last 5 years with SRH from a ruptured pancreaticoduodenal artery (PDA) aneurysm. Each patient had a unique presentation, complications and treatment demonstrating the variability and complexity of SRH. One patient presented with sudden abdominal pain and hypovolaemic shock, underwent angioembolisation and had an eventful recovery. Another patient presented similarly and was treated via angioembolisation but experienced gastric outlet obstruction and obstructive jaundice requiring surgical haematoma evacuation. Another patient had an incidental finding of haemoperitoneum during laparoscopic cholecystectomy that was subsequently diagnosed as SRH resulting from a PDA aneurysm rupture secondary to medial arcuate ligament syndrome.
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spelling pubmed-95779032022-10-19 Spontaneous retroperitoneal haemorrhage from pancreatoduodenal artery (PDA) rupture and associated complications Tan, Edmund Wooi Keat Shelat, Vishal G Monteiro, Amelia Yuting Low, Jee Keem BMJ Case Rep Case Reports: Unusual association of diseases/symptoms Spontaneous retroperitoneal haemorrhage (SRH) is rare. It may present with abdominal or back pain with or without haemodynamic instability. Aggressive resuscitation while investigating the cause of bleeding and providing haemostasis are the standard of care. Subsequent close monitoring is necessary to identify early complications. This study reports three patients who presented to our institution within the last 5 years with SRH from a ruptured pancreaticoduodenal artery (PDA) aneurysm. Each patient had a unique presentation, complications and treatment demonstrating the variability and complexity of SRH. One patient presented with sudden abdominal pain and hypovolaemic shock, underwent angioembolisation and had an eventful recovery. Another patient presented similarly and was treated via angioembolisation but experienced gastric outlet obstruction and obstructive jaundice requiring surgical haematoma evacuation. Another patient had an incidental finding of haemoperitoneum during laparoscopic cholecystectomy that was subsequently diagnosed as SRH resulting from a PDA aneurysm rupture secondary to medial arcuate ligament syndrome. BMJ Publishing Group 2022-10-17 /pmc/articles/PMC9577903/ /pubmed/36253011 http://dx.doi.org/10.1136/bcr-2022-250383 Text en © BMJ Publishing Group Limited 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Case Reports: Unusual association of diseases/symptoms
Tan, Edmund Wooi Keat
Shelat, Vishal G
Monteiro, Amelia Yuting
Low, Jee Keem
Spontaneous retroperitoneal haemorrhage from pancreatoduodenal artery (PDA) rupture and associated complications
title Spontaneous retroperitoneal haemorrhage from pancreatoduodenal artery (PDA) rupture and associated complications
title_full Spontaneous retroperitoneal haemorrhage from pancreatoduodenal artery (PDA) rupture and associated complications
title_fullStr Spontaneous retroperitoneal haemorrhage from pancreatoduodenal artery (PDA) rupture and associated complications
title_full_unstemmed Spontaneous retroperitoneal haemorrhage from pancreatoduodenal artery (PDA) rupture and associated complications
title_short Spontaneous retroperitoneal haemorrhage from pancreatoduodenal artery (PDA) rupture and associated complications
title_sort spontaneous retroperitoneal haemorrhage from pancreatoduodenal artery (pda) rupture and associated complications
topic Case Reports: Unusual association of diseases/symptoms
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9577903/
https://www.ncbi.nlm.nih.gov/pubmed/36253011
http://dx.doi.org/10.1136/bcr-2022-250383
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