Learning objectives
To revise the various non-traumatic abdominal bleeding causes, including post-procedural vascular complications.
To review the traumatic abdominalbleeding causes.
To present the typical imaging findings.
Background
In the past decade, great improvements have been made in the development of helical computed tomography (CT) that have led to shorter scanning time and higher spatial resolution.
Multidetector row CT angiography is the preferred method for imaging in emergent abdominal vascular conditions. Unlike catheter angiography, multidetector row CT angiography not only depicts the vessels but also allows the assessment of perfusion in adjacent organs.
Findings and procedure details
NON-TRAUMATIC ABDOMINAL BLEEDING:
1) VASCULAR CAUSES
a) RUPTURE OF ABDOMINAL ANEURYSMS/PSEUDOANEURYSMS
ABDOMINAL AORTIC ANEURYSM RUPTURE:
A diagnosis of a ruptured abdominal aortic aneurysm may be based on a non-enhanced CT scan that shows an aortic aneurysm with adjacent periaortic hemorrhage that extends into the perirenal and pararenal spaces of the retroperitoneum.
OTHER:
Less common vascular causes of spontaneous abdominal hemorrhage include rupture of a splanchnic artery aneurysm,mainly the splenic and hepatic arteries, and erosion of a vessel by an adjacent neoplastic or inflammatory disorder.
b)AORTOENTERIC...
Conclusion
Early recognition of vascular injuries is essential for rapid treatment and therefore, a successful outcome. Thus, a radiologist should be familiar with the different kinds of pathological abdominal vascular conditions and how to diagnose them.
Personal information and conflict of interest
Y. Lamprecht; Santander/ES - nothing to disclose A. B. Barba Arce; Torrelavega, CANTABRIA/ES - nothing to disclose E. Yllera Contreras; Burgos/ES - nothing to disclose M. M. Acebo Garcia; Santander/ES - nothing to disclose R. Pellon Daben; Santander/ES - nothing to disclose J. Crespo Del Pozo; Selaya, Cantabria, ESPAÑA/ES - nothing to disclose E. Marin; Santander/ES - nothing to disclose E. Montes Figueroa; Santander/ES - nothing to disclose P. Sanz Bellon; Santander/ES - nothing to disclose
References
Genovese E, Fonio P, Floridi C, Macchi M, Maccaferri A, Ianora A et al. Abdominal vascular emergencies: US and CT assessment. 2020.
Schwartz S, Taljanovic M, Smyth S, O'Brien M, Rogers L. CT Findings of Rupture, Impending Rupture, and Contained Rupture of Abdominal Aortic Aneurysms. American Journal of Roentgenology. 2007;188(1):W57-W62.
Siegel CL, Cohan RH, Korobkin M, Alpern MB, Courneya DL, Leder RA. Abdominal aortic aneurysm morphology: CT features in patients with ruptured and nonruptured aneurysms. AJR 1994; 163:1123–1129.
Furlan A, Fakhran S, Federle M. Spontaneous...
