Idiopathic Spontaneous Rupture of a Subcostal Artery in a Patient Undergoing Hemodialysis: A Case Report
The spontaneous rupture of a subcostal (12th intercostal) artery is exceptionally rare and could be fatal, requiring early diagnosis and treatment. Only one case of intercostal artery (ICA) bleeding in a patient undergoing hemodialysis (HD) has been reported. We additionally describe a 41-year-old m...
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MDPI AG
2024-03-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/60/3/439 |
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| author | Junha Ryu Seolje Lee Tae Won Lee Eunjin Bae Dong Jun Park |
| author_facet | Junha Ryu Seolje Lee Tae Won Lee Eunjin Bae Dong Jun Park |
| author_sort | Junha Ryu |
| collection | DOAJ |
| description | The spontaneous rupture of a subcostal (12th intercostal) artery is exceptionally rare and could be fatal, requiring early diagnosis and treatment. Only one case of intercostal artery (ICA) bleeding in a patient undergoing hemodialysis (HD) has been reported. We additionally describe a 41-year-old man undergoing HD who presented with a spontaneous hemoperitoneum and shock resulting from a subcostal artery rupture. He initially complained of diffuse abdominal pain and dizziness at the emergency room. His abdomen was bloated, and there was tenderness in the right upper quadrant area. Enhanced computed tomography and arteriography revealed a rupture of the right subcostal artery. After the super-selection of the bleeding artery by a microcatheter, embolization was performed using a detachable coil and gelfoam. In a subsequent arteriogram, additional contrast leakage was no longer detected, and his blood pressure was restored to normal. The patient was discharged without any sequelae. He was followed up at our HD center without recurrence of ICA bleeding. To the best of our knowledge, this is the second case in the English literature documenting a spontaneous ICA rupture in a patient undergoing HD. This case indicates that injury to ICA should be suspected when patients undergoing HD complain of abdominal or chest pain and dizziness, although it is very rare. |
| first_indexed | 2024-04-24T18:01:08Z |
| format | Article |
| id | doaj.art-08cfec5248fd4cebbae229373fe22bb4 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-04-24T18:01:08Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-08cfec5248fd4cebbae229373fe22bb42024-03-27T13:53:38ZengMDPI AGMedicina1010-660X1648-91442024-03-0160343910.3390/medicina60030439Idiopathic Spontaneous Rupture of a Subcostal Artery in a Patient Undergoing Hemodialysis: A Case ReportJunha Ryu0Seolje Lee1Tae Won Lee2Eunjin Bae3Dong Jun Park4Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon 51472, Republic of KoreaDepartment of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon 51472, Republic of KoreaDepartment of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon 51472, Republic of KoreaDepartment of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon 51472, Republic of KoreaDepartment of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon 51472, Republic of KoreaThe spontaneous rupture of a subcostal (12th intercostal) artery is exceptionally rare and could be fatal, requiring early diagnosis and treatment. Only one case of intercostal artery (ICA) bleeding in a patient undergoing hemodialysis (HD) has been reported. We additionally describe a 41-year-old man undergoing HD who presented with a spontaneous hemoperitoneum and shock resulting from a subcostal artery rupture. He initially complained of diffuse abdominal pain and dizziness at the emergency room. His abdomen was bloated, and there was tenderness in the right upper quadrant area. Enhanced computed tomography and arteriography revealed a rupture of the right subcostal artery. After the super-selection of the bleeding artery by a microcatheter, embolization was performed using a detachable coil and gelfoam. In a subsequent arteriogram, additional contrast leakage was no longer detected, and his blood pressure was restored to normal. The patient was discharged without any sequelae. He was followed up at our HD center without recurrence of ICA bleeding. To the best of our knowledge, this is the second case in the English literature documenting a spontaneous ICA rupture in a patient undergoing HD. This case indicates that injury to ICA should be suspected when patients undergoing HD complain of abdominal or chest pain and dizziness, although it is very rare.https://www.mdpi.com/1648-9144/60/3/439hemodialysisintercostal arteryhemorrhageembolization |
| spellingShingle | Junha Ryu Seolje Lee Tae Won Lee Eunjin Bae Dong Jun Park Idiopathic Spontaneous Rupture of a Subcostal Artery in a Patient Undergoing Hemodialysis: A Case Report Medicina hemodialysis intercostal artery hemorrhage embolization |
| title | Idiopathic Spontaneous Rupture of a Subcostal Artery in a Patient Undergoing Hemodialysis: A Case Report |
| title_full | Idiopathic Spontaneous Rupture of a Subcostal Artery in a Patient Undergoing Hemodialysis: A Case Report |
| title_fullStr | Idiopathic Spontaneous Rupture of a Subcostal Artery in a Patient Undergoing Hemodialysis: A Case Report |
| title_full_unstemmed | Idiopathic Spontaneous Rupture of a Subcostal Artery in a Patient Undergoing Hemodialysis: A Case Report |
| title_short | Idiopathic Spontaneous Rupture of a Subcostal Artery in a Patient Undergoing Hemodialysis: A Case Report |
| title_sort | idiopathic spontaneous rupture of a subcostal artery in a patient undergoing hemodialysis a case report |
| topic | hemodialysis intercostal artery hemorrhage embolization |
| url | https://www.mdpi.com/1648-9144/60/3/439 |
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