Embolisation of Epigastric Artery in a Massive Rectus Sheath Hematoma After Cardiac Valvular Surgery

Abstract

condition, it occurs more often in patients under anticoagulation therapy. It can mimic any type of acute abdomen, and sometimes the massive hematoma can be life-threatening.1 RSH is usually managed conservatively, but emergency surgery may be needed in cases with large or progressing hematomas with severe symptoms.2 Here we present a case of 55-year-old female presented with acute epigastric pain three weeks after triple cardiac valve surgery. Abdominal ultrasound (US) and computed tomography (CT) revealed large RSH and ongoing bleeding was detected by repeated US. We found out the RSH associated with superficial epigastric artery (SEA) bleeding by doing selective angiography of left internal mammarian artery (LIMA). The patient was treated successfully by embolization of the bleeding artery through LIMA.