Hepatic Pseudoaneurysm Incidence After Liver Trauma

Wagner, Mary Ann; Streit, Stephanie; Makley, Amy T.; Pritts, Timothy A.; Goodman, Michael D.

doi:10.1016/j.jss.2020.07.054

Cited by 28 publications

(39 citation statements)

References 27 publications

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“…A seven-year retrospective study at the University of California, Irvine Medical center found five cases of hepatic artery aneurysms among 18,015 trauma and surgical admissions (blunt abdominal trauma, liver biopsy, pancreatic pseudocyst, and polyarteritis nodosa), representing an incidence of 0.03%, in addition to two cases among 200 orthotopic liver transplants [ 16 ]. The incidence increases with higher-grade liver injury (III-IV), with a median identification time of 6.5 days after the injury [ 17 ]. The clinical presentation of HAPs may vary from incidental detection to an emergency presentation with rupture.…”

Section: Discussionmentioning

confidence: 99%

Hepatic Artery Pseudoaneurysm Following Gunshot Injury With Early Rupture

Ahmed¹,

Elkahly²,

Dada³

et al. 2021

Cureus

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Pseudoaneurysms are a rare and potentially life-threatening complication that can be caused by trauma, infections, tumors, autoimmune diseases, organ transplants, or idiopathic causes. The management of liver trauma is based on the anatomy of the injury and the patient's physiology. Posttraumatic hepatic artery pseudoaneurysm (HAP) is a life-threatening complication that requires prompt recognition and a multidisciplinary approach in its management. We present a case of HAP rupture two weeks following a gunshot wound to the liver.

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Section: Discussionmentioning

confidence: 99%

Hepatic Artery Pseudoaneurysm Following Gunshot Injury With Early Rupture

Ahmed¹,

Elkahly²,

Dada³

et al. 2021

Cureus

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“…Conversely, a recent large study by Wagner et al . [ 12 ] documented that 18 patients out of 600 trauma patients had hepatic pseudoaneurysm. Seven pseudoaneurysms were found on asymptomatic surveillance CT angiography, and 11 patients were symptomatic at the time of scan surveillance.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors suggested 24–48 h after abdominal blunt injury [ 11 ]. However, others recommended 5 and 7 days from the original trauma [ 12 ]. In the current case, initial follow-up CT scan angiography on the fifth day after the injury did not identify pseudoaneurysm.…”

Section: Discussionmentioning

confidence: 99%

Late development of giant hepatic artery pseudoaneurysm following abdominal trauma due to tire blast: case report and literature review

Mahmood

Kasim

El‐Menyar

et al. 2021

Journal of Surgical Case Reports

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Giant hepatic artery pseudoaneurysm is rare but could have a significant implication. A 35-year-old male was severely injured by a truck tire explosion and presented with hypotension and positive focused assessment with sonography in trauma scan. After resuscitation, abdomen computed tomography (CT) scan showed a Grade 4 liver injury. The patient was admitted to the intensive care unit, and the liver injury was treated conservatively. Seventeen days later, he developed abdominal pain with deep epigastric tenderness. Repeated abdomen CT scan detected a giant hepatic artery pseudoaneurysm. Embolization was achieved using gel foam with the placement of six microcoils. The patient had an uneventful recovery. Late development of giant hepatic artery pseudoaneurysm is a rare complication of hepatic trauma and could be life-threatening. Timely identification and treatment with endovascular intervention are crucial. We recommend, especially when dealing with trauma related to blast injury, follow-up images for patients who develop symptoms suggestive of hepatic injury.

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“…Blunt liver trauma can be responsible for deadly outcomes. Autopsy case studies have shown that lacerations, followed by hematomas [ 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ], represent the most frequent lesion. Another unusual cause of hemorrhage, which may be associated with delayed death from trauma, is the rupture of a post-traumatic hepatic artery aneurysm [ 44 ].…”

Section: Medico-legal Implications Of Hepatic Traumamentioning

confidence: 99%

Liver Trauma: Management in the Emergency Setting and Medico-Legal Implications

et al. 2022

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Traumatic abdominal injuries are life-threatening emergencies frequently seen in the Emergency Department (ED). The most common is liver trauma, which accounts for approximately 5% of all ED admissions for trauma. The management of blunt liver trauma has evolved significantly over the past few decades and, according to the injury’s severity, it may require massive resuscitation, radiological procedures, endoscopy, or surgery. Patients admitted to the ED with blunt abdominal trauma require a multidisciplinary evaluation, including emergency physicians, surgeons, radiologists, and anesthetists, who must promptly identify the extent of the injury to prevent serious complications. In case of a patient’s death, the execution of a forensic examination carried out with a multidisciplinary approach (radiological, macroscopic, and histological) is essential to understand the cause of death and to correlate the extent of the injuries to the possibility of survival to be able to manage any medico-legal disputes. This manuscript aims to collect the most up-to-date evidence regarding the management of hepatic trauma in the emergency room and to explore radiological findings and medico-legal implications.

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Hepatic Pseudoaneurysm Incidence After Liver Trauma

Cited by 28 publications

References 27 publications

Hepatic Artery Pseudoaneurysm Following Gunshot Injury With Early Rupture

Hepatic Artery Pseudoaneurysm Following Gunshot Injury With Early Rupture

Late development of giant hepatic artery pseudoaneurysm following abdominal trauma due to tire blast: case report and literature review

Liver Trauma: Management in the Emergency Setting and Medico-Legal Implications

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