INFERIOR EPIGASTRIC ARTERY PSEUDOANEURYSM - A COMPLICATION OF PARACENTESIS

Two patients had inferior epigastric artery pseudoaneurysms after ther apeutic paracentesis for ascites caused by portal hypertension. The fi rst patient, a 62-year-old man, had a two-week history of left lower q uadrant pain, tenderness, and nonpulsatile mass after a paracentesis f or ascites. A left inferior epigastric artery pseudoaneurysm measuring 10 cm in diameter and 20 cm in length was diagnosed by means of Duple x ultrasound and arteriography. The patient was treated with percutane ous embolization, with successful thrombosis of the pseudoaneurysm The second patient, a 33-year-old woman, had a six-week history of left l ower quadrant pain, tenderness, and nonpulsatile mass after a paracent esis for ascites. Computerized tomography and arteriography showed a l eft inferior epigastric artery pseudoaneurysm, measuring 7 cm in diame ter and 9 cm in length. The patient was treated with percutaneous embo lization with successful thrombosis of the pseudoaneurysm. Both patien ts were discharged in good condition 2 days after embolization. Inferi or epigastric artery pseudoaneurysm is a complication of paracentesis, and percutaneous embolization may be preferable to surgical repair in patients with chronic liver failure and portal hypertension.