Endovascular embolisation of a hepatic pseudoaneurysm causing massive hemorrhage after a blunt hepatic trauma

Hepatic artery pseudoaneurysm is an uncommon and a latecomplication after a blunt hepatic trauma. Although hepatic arterypseudoaneurysms may stay silent, it is usually better to treat themdue to the high hemorrhage risk they cause. We are presenting apatient with post traumatic hepatic laceration who had seriousbleeding with late onset after percutaneous drainage of the oldhematoma. On a multidetector computerised tomography (MDCT)scan, a large hematoma surrounding a pseudoaneurysm wasdiagnosed which was treated with endovascular cyanoacrylate(glue) embolisation.

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Hepatic artery pseudoaneurysm is an uncommon and a late complication after a blunt hepatic trauma. Although hepatic artery pseudoaneurysms may stay silent, it is usually better to treat them due to the high hemorrhage risk they cause. We are presenting a patient with post traumatic hepatic laceration who had serious bleeding with late onset after percutaneous drainage of the old hematoma. On a multidetector computerised tomography (MDCT) scan, a large hematoma surrounding a pseudoaneurysm was diagnosed which was treated with endovascular cyanoacrylate (glue) embolisation.

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  • Moore EE, Cogbill TH, Jurkovich GJ, Shackford SR, Malangoni MA, Champion HR. Organ injury scaling: spleen and liver (1994 revision). J Trauma 1995 ;38:323-4. doi:http://dx.doi.org/10.1097/00005373199503000-00001
  • Malhotra AK, Fabian TC, Croce MA et al. Blunt hepatic injury: a paradigm shift from operative to nonoperative management in the 1 9 9 0 s . A n n S u rg 2 0 0 0 ; 2 3 1 : 8 0 4 – 1 3 . d o i : d x . d o i . org/1097/00000658-200006000-00004
  • Velmahos GC, Toutouzas K, Radin R, et al. High success with nonoperative management of blunt hepatic trauma: the liver is a sturdy organ. Arch Surg 2003;138:475–81. doi: dx.doi.org/10.1001/ archsurg.138.5.475
  • David Richardson J, Franklin GA, Lukan JK, et al. Evolution in the management of hepatic trauma: a 25-year perspective. Ann Surg 2000;232:324–30.dx.doi.org/10.1097/00000658-200009000-00004
  • Croce MA, Fabian TC, Spiers JP, Kudsk KA. Traumatic hepatic artery pseudoaneurysm with hemobilia. Am J Surg 1994;168:235–8. doi:dx. doi.org/10.1016/S0002-9610(05)80193-X
  • Yoon W, Jeong YY, Kim JK, et al. CT in blunt liver trauma. Radiographics 2005;25:87–104. doi: dx.do.org/10.1148/rg.251045079
  • Pachter HL, Knudson MM, Esrig B, et al. Status of nonoperative management of blunt hepatic injuries in 1995: a multicenter experience with 404 patients. J Trauma 1996;40:31–8. doi: dx.doi. org/1097/00005373-199601000-00007.
  • Dambrin C, Marcheix B, Birsan T, et al. Posttraumatic pseudoaneurysm of the hepatic artery: treatment with ultrasound-guided percutaneous transhepatic thrombin injection. J Trauma 2005;59:239–42. doi: http://dx.doi.org/10.1097/01.TA.0000171526.24911.B2
  • Paci E, Antico E, Candelari R, Alborino S, Marmorale C, Landi E. Pseudoaneurysm of the common hepatic artery: treatment with a stent-graft. Cardiovasc Intervent Radiol 2000;23:472–4.http://dx.doi. org/1007/s002700010107
  • Kim DJ, Willinsky RA, Krings T, Agid R, Terbrugge K. Intracranial dural arteriovenous shunts: transarterial glue embolization--experience in 115 consecutive patients. Radiology 2011 ;258:554-61. doi: http:// dx.doi.org/10.1148/radiol.10100755
Marmara Medical Journal-Cover
  • ISSN: 1019-1941
  • Yayın Aralığı: Yılda 3 Sayı
  • Başlangıç: 1988
  • Yayıncı: Marmara Üniversitesi