Pathologie de l'artère hépatique

Launois, B.; Bohmer, R.; Maddern, G.

doi:10.1016/s1155-1976(04)23124-2

Cited by 2 publications

(5 citation statements)

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“…In the present case, surgical treatment of HPF is strongly indicated for extrahepatic HPF because of large size, frequently associated pseudo-aneurysm, and the imperative to maintain hepatic arterial flow: endovascular treatments are not indicated for these forms of HPF [2].…”

Section: Discussionmentioning

confidence: 90%

“…About 20% of cases are directly due to trauma, especially when liver contusion or penetrating wounds result in simultaneous injury to the hepatic artery and portal vein. Twenty percent of HPF are due to delayed rupture of an hepatic artery aneurysm into the portal vein [2].…”

Section: Discussionmentioning

confidence: 99%

“…Operative view: resection of the aneurysmal sac and closure of the portal vein defect (1); end-to-end arterial anastomosis(2).…”

mentioning

confidence: 99%

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Post-traumatic arteriovenous fistula of the hepatic pedicle

Hassani

Mohsine

Belkouchi

et al. 2010

Journal of Visceral Surgery

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Hepatico-portal fistula (HPF) is a rare condition, most often of post-traumatic or iatrogenic origin and occasionally secondary to a ruptured aneurysm of the hepatic artery into the portal vein. HPF in extrahepatic locations often results in portal hypertension (PHT). While Doppler ultrasound, CT angiography, and magnetic resonance angiography are usually demonstrative, arteriography remains indispensable to clarify the exact anatomical configuration. In the treatment of these arteriovenous (AV) fistulas, open surgical approaches have increasingly given way to radiological embolization techniques, especially in intrahepatic locations, but surgery remains indicated for AV fistulas of the hepatic pedicle where maintenance of hepatic arterial flow is a priority of treatment. We report a patient who had an AV fistula of the hepatic pedicle with resultant PHT presenting 5 years after open abdominal trauma. Treatment was surgical; the immediate and long-term postoperative course was uneventful with regression of PHT. Through analysis of this case and a review of the literature, we discuss the clinical, paraclinical, therapeutic, and prognostic features of this lesion.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Post-traumatic arteriovenous fistula of the hepatic pedicle

Hassani

Mohsine

Belkouchi

et al. 2010

Journal of Visceral Surgery

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“…En 1976, Walter et al ont rapporté le premier cas d'embolisation sélective de l'artère hépatique (15). Depuis, l'embolisation artérielle sélective est devenue le traitement de référence et reste préférable à la chirurgie (5,13). La décision du mode de prise en charge, chirurgicale ou conservatrice, ne se base pas uniquement sur le grade de la lésion au scanner mais aussi sur le statut hémodynamique du patient.…”

Section: Discussionunclassified

“…L'avantage de l'embolisation sur la chirurgie est une meilleure hémostase, avec une occlusion des vaisseaux plus distale ; elle permet aussi d'éviter une chirurgie lourde chez ces patients. Le risque de nécrose hépatique devrait être minimal puisque l'oblitération artérielle peut se limiter à une branche segmentaire de l'artère hépatique (5,13). La morbidité de ce geste, d'environ 10%, est dominée par le risque d'embolisation inappropriée et d'abcès du foie (1).…”

Section: Discussionunclassified