Spontaneous omental bleeding: a case report and literature review
Abstract Background Spontaneous rupture of omental vessels is an infrequent medical condition possibly causing severe intra-abdominal hemorrhage. Omental bleeding results from trauma associated injury and irritation, neoplasia, arterial aneurysm rupture, and anticoagulant treatment. Idiopathic oment...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-05-01
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| Series: | BMC Surgery |
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| Online Access: | http://link.springer.com/article/10.1186/s12893-018-0364-9 |
| _version_ | 1818486584819843072 |
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| author | Yun-Xiao Lyu Yun-Xiao Cheng Ting Li |
| author_facet | Yun-Xiao Lyu Yun-Xiao Cheng Ting Li |
| author_sort | Yun-Xiao Lyu |
| collection | DOAJ |
| description | Abstract Background Spontaneous rupture of omental vessels is an infrequent medical condition possibly causing severe intra-abdominal hemorrhage. Omental bleeding results from trauma associated injury and irritation, neoplasia, arterial aneurysm rupture, and anticoagulant treatment. Idiopathic omental bleeding rarely causes acute abdominal bleeding which has been reported to occur in previous studies. Here we reported a case with idiopathic omental hemorrhage due to vascular malformation. A systematic review of literature is provided. Case presentation A 58-year-old Han Chinese man arrived at the emergency department with left upper quadrant abdominal pain for 1 day. He had no significant previous medical history. There was no history of fever, vomiting, nausea, or anorexia. He was a non-smoker and did not consume alcohol. On physical examination, blood pressure was 118/72 mmHg, for a temperature of 37.7 °C; heart and respiratory rates of 130 per/min and 20 per/min were obtained, respectively. Abdomen assessment showed only mild tenderness in the left upper quadrant. Complete blood count (CBC) showed white cell and platelet counts of 16.69 × 103/L and 196 × 103/L, respectively. The haemoglobin value was 13.5 g/L at admission. Abdominal Computer Tomography (CT) was performed that showed peritoneal fluid appeared around the liver. Fresh blood was confirmed in the abdominocentesis. A hemoperitoneum was confirmed by abdominal enhanced CT, which presented a structural disorder in the left upper abdomen. The subject immediately underwent exploratory laparotomy. A massive hemoperitoneum originating from omental vessels was observed. The omental were partially removed. There was no evidence of malignancy or aneurysm upon palpation. Pathological assessment of the extracted tissue pointed to vascular malformation. The patient subsequently had an uneventful recovery; hospital discharge occurred at 7 days post-operation. Previous reports assessing idiopathic omental bleeding were systematically reviewed, summarizing published cases. A total of 12 hits were found in PubMed for idiopathic omental bleeding. Conclusion Idiopathic omental bleeding is a rare condition that requires emergency treatment. Treatment strategies include surgical intervention and transcatheter arterial embolization (TAE). The surgical option is suitable in subjects with persistent hypotension and those with unconfirmed diagnosis. |
| first_indexed | 2024-12-10T16:24:57Z |
| format | Article |
| id | doaj.art-7aec4607d7d348a495d55af0a098ce30 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-12-10T16:24:57Z |
| publishDate | 2018-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-7aec4607d7d348a495d55af0a098ce302022-12-22T01:41:42ZengBMCBMC Surgery1471-24822018-05-011811410.1186/s12893-018-0364-9Spontaneous omental bleeding: a case report and literature reviewYun-Xiao Lyu0Yun-Xiao Cheng1Ting Li2Department of Hepatobiliary Surgery, Dongyang People’s HospitalDepartment of Hepatobiliary Surgery, Dongyang People’s HospitalDongyang People’s HospitalAbstract Background Spontaneous rupture of omental vessels is an infrequent medical condition possibly causing severe intra-abdominal hemorrhage. Omental bleeding results from trauma associated injury and irritation, neoplasia, arterial aneurysm rupture, and anticoagulant treatment. Idiopathic omental bleeding rarely causes acute abdominal bleeding which has been reported to occur in previous studies. Here we reported a case with idiopathic omental hemorrhage due to vascular malformation. A systematic review of literature is provided. Case presentation A 58-year-old Han Chinese man arrived at the emergency department with left upper quadrant abdominal pain for 1 day. He had no significant previous medical history. There was no history of fever, vomiting, nausea, or anorexia. He was a non-smoker and did not consume alcohol. On physical examination, blood pressure was 118/72 mmHg, for a temperature of 37.7 °C; heart and respiratory rates of 130 per/min and 20 per/min were obtained, respectively. Abdomen assessment showed only mild tenderness in the left upper quadrant. Complete blood count (CBC) showed white cell and platelet counts of 16.69 × 103/L and 196 × 103/L, respectively. The haemoglobin value was 13.5 g/L at admission. Abdominal Computer Tomography (CT) was performed that showed peritoneal fluid appeared around the liver. Fresh blood was confirmed in the abdominocentesis. A hemoperitoneum was confirmed by abdominal enhanced CT, which presented a structural disorder in the left upper abdomen. The subject immediately underwent exploratory laparotomy. A massive hemoperitoneum originating from omental vessels was observed. The omental were partially removed. There was no evidence of malignancy or aneurysm upon palpation. Pathological assessment of the extracted tissue pointed to vascular malformation. The patient subsequently had an uneventful recovery; hospital discharge occurred at 7 days post-operation. Previous reports assessing idiopathic omental bleeding were systematically reviewed, summarizing published cases. A total of 12 hits were found in PubMed for idiopathic omental bleeding. Conclusion Idiopathic omental bleeding is a rare condition that requires emergency treatment. Treatment strategies include surgical intervention and transcatheter arterial embolization (TAE). The surgical option is suitable in subjects with persistent hypotension and those with unconfirmed diagnosis.http://link.springer.com/article/10.1186/s12893-018-0364-9Omental bleedingDiagnosisComputerd tomographySurgeryTranscatheter arterial embolization |
| spellingShingle | Yun-Xiao Lyu Yun-Xiao Cheng Ting Li Spontaneous omental bleeding: a case report and literature review BMC Surgery Omental bleeding Diagnosis Computerd tomography Surgery Transcatheter arterial embolization |
| title | Spontaneous omental bleeding: a case report and literature review |
| title_full | Spontaneous omental bleeding: a case report and literature review |
| title_fullStr | Spontaneous omental bleeding: a case report and literature review |
| title_full_unstemmed | Spontaneous omental bleeding: a case report and literature review |
| title_short | Spontaneous omental bleeding: a case report and literature review |
| title_sort | spontaneous omental bleeding a case report and literature review |
| topic | Omental bleeding Diagnosis Computerd tomography Surgery Transcatheter arterial embolization |
| url | http://link.springer.com/article/10.1186/s12893-018-0364-9 |
| work_keys_str_mv | AT yunxiaolyu spontaneousomentalbleedingacasereportandliteraturereview AT yunxiaocheng spontaneousomentalbleedingacasereportandliteraturereview AT tingli spontaneousomentalbleedingacasereportandliteraturereview |