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Clinical Images

Abdominal Pain

Pietro Sergio, MD
October 24, 2014

A 66-year-old woman was admitted to the emergency department for vague upper abdominal pain of several days duration. She was hemodynamically stable and her past history was unremarkable. An abdomen ultrasound examination was performed, which revealed no significant findings. A few hours after her initial presentation, there was a slight increase in the abdominal pain, which was located in the epigastric region, and a reduction in her hemoglobin value from 12.3 g/dL to 11.2 g/dL. A subsequent contrast-enhanced abdominal CT was performed and showed a retroperitoneal hematoma with a hyperdense lesion measuring 15 mm x 15 mm within it (Figure 1 and 2). Moreover, at a more cephalic level, an atherosclerotic aneurysm of the celiac artery with luminal narrowing was detected. 


Figure 1
Axial-CT image shows a large retroperitoneal hematoma (arrow) with a hyperdense lesion (arrow) within it.


Figure 2
MIP-CT image shows, on a coronal plane, a hyperdense lesion.

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Bageacu et al (2006) True aneurysms of the pancreaticoduodenal artery: successful non-operative management. Surgery 139:608-16

Author bio: 

Pietro Sergio is currently a radiologist at Istituti Ospitalieri di Cremona - CREMONA, Italy