Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492008000400016
Jornal Vascular Brasileiro
Case Report

Sangramento espontâneo de artéria lombar em paciente com doença de Von Recklinghausen: tratamento endovascular

Spontaneous lumbar artery bleeding in patient with Von Recklinghausen’s disease: endovascular treatment

Felipe Nasser; Breno Boueri Affonso; Charles Edouard Zurstrassen; Wilson de Oliveira Sousa Junior; Joaquim Mauricio da Motta Leal Filho; Fabio Yamada; Paulo Henrique Petterle; Francisco Cesar Carnevale

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Resumo

Os sangramentos no retroperitônio são, em sua grande maioria, secundários a eventos traumáticos envolvendo grande energia cinética, com poucos relatos na literatura caracterizados como espontâneos. No presente relato, descrevemos paciente gestante, portadora de doença de Von Recklinghausen e com volumoso hematoma retroperitoneal diagnosticado durante o parto cesariano, secundário a ruptura espontânea de artéria lombar. A doença de Von Recklinghausen apresenta manifestações vasculares bem descritas, caracterizando-se principalmente por estenoses que são secundárias a tumores intramurais (proliferação das células de Schwann) e raramente dilatações aneurismáticas, assintomáticas em sua maioria. No presente caso, foi realizada a aortografia com cateterização seletiva e embolização da artéria sangrante com sucesso.

Palavras-chave

Hematoma, doença de Von Recklinghausen, artéria, embolização terapêutica

Abstract

Retroperitoneal bleeding is mainly due to traumatic events with a high amount of kinetic energy, with few reported cases of spontaneous events in the literature. We report on a case of a pregnant woman with Von Recklinghausen"s disease and bulky retroperitoneal hematoma diagnosed during cesarean delivery secondary to spontaneous lumbar artery rupture. Von Recklinghausen"s disease has well-described vascular manifestations, mainly characterized by stenoses related to intramural tumors (Schwann cell proliferation) and rarely asymptomatic aneurysmal dilatations. In this case, aortography was performed with successful selective catheterization and embolization of the bleeding artery.

Keywords

Hematoma, von Recklinghausen"s disease, artery, therapeutic embolization

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