PMC10285080_01
Unenhanced and contrast-enhanced abdominal CT images of a 48-year-old male patient. Unenhanced abdominal CT scans (A-C) showed encapsulated effusion in the middle part of the pelvic cavity, with accumulation of small amounts of gas [(A), white arrow], and the lesion was ~4.5 cm x 5.5 cm, pelvic abscess formation was considered. A long strip-shaped slightly dense shadow was visible at the level below the pelvic abscess [(B), red arrow], which was considered to be a pelvic foreign body. The length of the foreign body measured on the multiplanar reconstruction image was ~5.5 cm [(C), red arrow]. Enhanced CT images in the arterial phase showed a pseudoaneurysm originating from right common iliac artery [(D), purple arrow]. The size of the pseudoaneurysms was ~1.5 cm x 1.7 cm, with an entry tear of ~6 mm.
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F1
CT revealed encapsulated effusion in the middle part of the pelvic cavity, pelvic abscess was considered (Figure 1A, white arrow), and a long strip-shaped foreign body was visible below the level of the pelvic abscess (Figures 1B, C, red arrow). Contrast-enhanced CT image revealed a pseudoaneurysm originating from right common iliac artery (Figure 1D, purple arrow).
Volume-rendered, arterial-phase, contrast-enhanced CT image (A) and digital subtraction angiography (DSA) (B) of a 48-year-old male patient revealed a pseudoaneurysm originating from the right common iliac artery (purple arrow), the size of the pseudoaneurysm was ~1.8 cm x 2.1 cm, with an entry tear of ~6 mm. (C) DSA re-examination after stent placement showed complete disappearance of the pseudoaneurysm (black arrow).
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F2
Volume-rendered arterial phase CT image and digital subtraction angiography (DSA) confirmed the presence of a pseudoaneurysm originating from the right common iliac artery (Figures 2A, B, purple arrow). DSA showed complete disappearance of pseudoaneurysm (Figure 2C, black arrow). Due to the presence of intra-abdominal infection, the patient received anti-infection therapy with imipenem cilastatin sodium after surgery (250 mg every 6 h for a week), and he recovered well after surgery without further GI bleeding.
The foreign body was confirmed to be a toothpick (arrow) during exploratory laparotomy (A) and removed after surgery (B).
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F3
The patient underwent exploratory laparotomy, and the foreign body was finally confirmed to be a toothpick (Figures 3A, B).
Medical timeline of the patient with small bowel bleeding. CT, computed tomography; DSA, digital subtraction angiography.
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F4
Medical timeline of the patient is shown in Figure 4.