Inferior epigastric pseudoaneurysm and rectus sheath hematoma treated with percutaneous direct sac puncture and embolization with NBCA

Rectus sheath hematomas are most commonly observed in elderly patients on anticoagulation and may require embolization when there is accompanying hemodynamic instability or vascular injury. We present a case of an inferior epigastric pseudoaneurysm and rectus sheath hematoma treated by percutaneous...

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Main Authors: Jacob Schick, MD, David Gage, MD, Christopher Bailey, MD
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Radiology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S1930043325001736
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author Jacob Schick, MD
David Gage, MD
Christopher Bailey, MD
author_facet Jacob Schick, MD
David Gage, MD
Christopher Bailey, MD
author_sort Jacob Schick, MD
collection DOAJ
description Rectus sheath hematomas are most commonly observed in elderly patients on anticoagulation and may require embolization when there is accompanying hemodynamic instability or vascular injury. We present a case of an inferior epigastric pseudoaneurysm and rectus sheath hematoma treated by percutaneous direct sac puncture with N‑butyl cyanoacrylate (NBCA) glue due to complex vascular anatomy and body habitus which limited an intra-arterial approach. While superficial pseudoaneurysms are often managed with thrombin, liquid embolics may offer improved penetration into the afferent and efferent supply of the pseudoaneurysm, thereby limiting re-bleeding risk.
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spelling doaj-art-fcf9728948464feca83da7dae298ac3a2025-08-20T03:09:00ZengElsevierRadiology Case Reports1930-04332025-06-012062937293910.1016/j.radcr.2025.02.073Inferior epigastric pseudoaneurysm and rectus sheath hematoma treated with percutaneous direct sac puncture and embolization with NBCAJacob Schick, MD0David Gage, MD1Christopher Bailey, MD2Corresponding author.; The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore, MDThe Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore, MDThe Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore, MDRectus sheath hematomas are most commonly observed in elderly patients on anticoagulation and may require embolization when there is accompanying hemodynamic instability or vascular injury. We present a case of an inferior epigastric pseudoaneurysm and rectus sheath hematoma treated by percutaneous direct sac puncture with N‑butyl cyanoacrylate (NBCA) glue due to complex vascular anatomy and body habitus which limited an intra-arterial approach. While superficial pseudoaneurysms are often managed with thrombin, liquid embolics may offer improved penetration into the afferent and efferent supply of the pseudoaneurysm, thereby limiting re-bleeding risk.http://www.sciencedirect.com/science/article/pii/S1930043325001736EmbolizationPseudoaneurysmRectus sheath hematomaNBCA
spellingShingle Jacob Schick, MD
David Gage, MD
Christopher Bailey, MD
Inferior epigastric pseudoaneurysm and rectus sheath hematoma treated with percutaneous direct sac puncture and embolization with NBCA
Radiology Case Reports
Embolization
Pseudoaneurysm
Rectus sheath hematoma
NBCA
title Inferior epigastric pseudoaneurysm and rectus sheath hematoma treated with percutaneous direct sac puncture and embolization with NBCA
title_full Inferior epigastric pseudoaneurysm and rectus sheath hematoma treated with percutaneous direct sac puncture and embolization with NBCA
title_fullStr Inferior epigastric pseudoaneurysm and rectus sheath hematoma treated with percutaneous direct sac puncture and embolization with NBCA
title_full_unstemmed Inferior epigastric pseudoaneurysm and rectus sheath hematoma treated with percutaneous direct sac puncture and embolization with NBCA
title_short Inferior epigastric pseudoaneurysm and rectus sheath hematoma treated with percutaneous direct sac puncture and embolization with NBCA
title_sort inferior epigastric pseudoaneurysm and rectus sheath hematoma treated with percutaneous direct sac puncture and embolization with nbca
topic Embolization
Pseudoaneurysm
Rectus sheath hematoma
NBCA
url http://www.sciencedirect.com/science/article/pii/S1930043325001736
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