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Inferior epigastric artery pseudoaneurysm: ultrasound diagnosis and treatment with percutaneous thrombin

Department of Radiology, Western Infirmary NHS Trust, Dumbarton Road, Glasgow G11 6NT, UK

View larger version (77K): [in a new window]   Figure 1. (a) Scanning was initially peformed with a 3.5 MHz sector probe. A mixed echogenic mass was seen within the rectus sheath (arrows). (b) Using a broadband, high frequency linear array probe (5–12 MHz), more detail was obtained and suggested the diagnosis of rectus sheath haematoma. (c) Colour Doppler ultrasound showed a hypervascular nidus (long arrow) consistent with a pseudoaneurysm. The jet of the pseudoaneurysm (arrowhead) was seen to arise from the inferior epigastric artery. (d) Spectral Doppler waveform of the jet demonstrated the "to and fro" sign.

View larger version (11K): [in a new window]   Figure 2. (a) The tip of the 22 G needle (arrow) is seen within the pseudoaneurysm sac. Percutaneous thrombin (400 international units) was injected. (b) Following thrombin injection the psuedoaneurysm was completely ablated. The inferior epigastric artery is patent (arrow).