Intraperitoneal Bleeding Induced by a Ruptured Inferior Epigastric Artery Pseudoaneurysm following Interval Debulking Surgery for Ovarian Cancer: A Case Report

Introduction: Pseudoaneurysm following gynecologic cancer surgery is a rare complication that can become fatal when it ruptures. Common sites of pseudoaneurysms are the external iliac artery, hypogastric artery, and aorta, which are located around the lymphadenectomy site. There are...

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Main Authors: Shota Higami, Yasuyuki Kinjo, Mao Sekimata, Yuta Yoshimatsu, Yu Murakami, Tomoko Kurita, Kiyoshi Yoshino
Format: Article
Language:English
Published: Karger Publishers 2024-12-01
Series:Case Reports in Oncology
Online Access:https://karger.com/article/doi/10.1159/000543127
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author Shota Higami
Yasuyuki Kinjo
Mao Sekimata
Yuta Yoshimatsu
Yu Murakami
Tomoko Kurita
Kiyoshi Yoshino
author_facet Shota Higami
Yasuyuki Kinjo
Mao Sekimata
Yuta Yoshimatsu
Yu Murakami
Tomoko Kurita
Kiyoshi Yoshino
author_sort Shota Higami
collection DOAJ
description Introduction: Pseudoaneurysm following gynecologic cancer surgery is a rare complication that can become fatal when it ruptures. Common sites of pseudoaneurysms are the external iliac artery, hypogastric artery, and aorta, which are located around the lymphadenectomy site. There are no previous reports of ruptured inferior epigastric (IEA) artery pseudoaneurysms after gynecologic cancer surgery. We report a case of intraperitoneal bleeding induced by a ruptured IEA pseudoaneurysm following interval debulking surgery for stage IVB ovarian cancer. Case Presentation: The patient underwent total abdominal simple hysterectomy, bilateral salpingo-oophorectomy, omentectomy, ileocolic resection, and peritonectomy around the ileocecal area after 5 cycles of neoadjuvant chemotherapy. The patient suddenly presented with loss of consciousness and reduced blood pressure on postoperative day 20. Her blood hemoglobin levels also decreased. Contrast-enhanced computed tomography revealed a pseudoaneurysm in the right IEA. There were no signs of extravasation from the pseudoaneurysm; however, bloody ascites was observed in the abdominal cavity. A ruptured IEA pseudoaneurysm was suspected, and coil embolization was immediately performed. Her symptoms abated soon after coil embolization, and she remained symptom-free during the 8 months of postoperative follow-up. Conclusion: Awareness of this rare complication is clinically important for its early detection and treatment.
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spelling doaj-art-1b3a3f48a0984aa69c08d01ab5cd031b2025-08-20T03:09:47ZengKarger PublishersCase Reports in Oncology1662-65752024-12-0118113714310.1159/000543127Intraperitoneal Bleeding Induced by a Ruptured Inferior Epigastric Artery Pseudoaneurysm following Interval Debulking Surgery for Ovarian Cancer: A Case ReportShota HigamiYasuyuki KinjoMao SekimataYuta YoshimatsuYu MurakamiTomoko KuritaKiyoshi Yoshino Introduction: Pseudoaneurysm following gynecologic cancer surgery is a rare complication that can become fatal when it ruptures. Common sites of pseudoaneurysms are the external iliac artery, hypogastric artery, and aorta, which are located around the lymphadenectomy site. There are no previous reports of ruptured inferior epigastric (IEA) artery pseudoaneurysms after gynecologic cancer surgery. We report a case of intraperitoneal bleeding induced by a ruptured IEA pseudoaneurysm following interval debulking surgery for stage IVB ovarian cancer. Case Presentation: The patient underwent total abdominal simple hysterectomy, bilateral salpingo-oophorectomy, omentectomy, ileocolic resection, and peritonectomy around the ileocecal area after 5 cycles of neoadjuvant chemotherapy. The patient suddenly presented with loss of consciousness and reduced blood pressure on postoperative day 20. Her blood hemoglobin levels also decreased. Contrast-enhanced computed tomography revealed a pseudoaneurysm in the right IEA. There were no signs of extravasation from the pseudoaneurysm; however, bloody ascites was observed in the abdominal cavity. A ruptured IEA pseudoaneurysm was suspected, and coil embolization was immediately performed. Her symptoms abated soon after coil embolization, and she remained symptom-free during the 8 months of postoperative follow-up. Conclusion: Awareness of this rare complication is clinically important for its early detection and treatment. https://karger.com/article/doi/10.1159/000543127
spellingShingle Shota Higami
Yasuyuki Kinjo
Mao Sekimata
Yuta Yoshimatsu
Yu Murakami
Tomoko Kurita
Kiyoshi Yoshino
Intraperitoneal Bleeding Induced by a Ruptured Inferior Epigastric Artery Pseudoaneurysm following Interval Debulking Surgery for Ovarian Cancer: A Case Report
Case Reports in Oncology
title Intraperitoneal Bleeding Induced by a Ruptured Inferior Epigastric Artery Pseudoaneurysm following Interval Debulking Surgery for Ovarian Cancer: A Case Report
title_full Intraperitoneal Bleeding Induced by a Ruptured Inferior Epigastric Artery Pseudoaneurysm following Interval Debulking Surgery for Ovarian Cancer: A Case Report
title_fullStr Intraperitoneal Bleeding Induced by a Ruptured Inferior Epigastric Artery Pseudoaneurysm following Interval Debulking Surgery for Ovarian Cancer: A Case Report
title_full_unstemmed Intraperitoneal Bleeding Induced by a Ruptured Inferior Epigastric Artery Pseudoaneurysm following Interval Debulking Surgery for Ovarian Cancer: A Case Report
title_short Intraperitoneal Bleeding Induced by a Ruptured Inferior Epigastric Artery Pseudoaneurysm following Interval Debulking Surgery for Ovarian Cancer: A Case Report
title_sort intraperitoneal bleeding induced by a ruptured inferior epigastric artery pseudoaneurysm following interval debulking surgery for ovarian cancer a case report
url https://karger.com/article/doi/10.1159/000543127
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