Post-traumatic Pseudoaneurysm of Hepatic Artery: An Unusual Cause of Upper Gastrointestinal Bleeding

Prasad, Arun; Prasad, Abhiranjan; Kumar, Pradeep; Kumar, Subhash

doi:10.1007/s13312-020-1796-8

Cited by 7 publications

(3 citation statements)

References 8 publications

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“…A precise diagnosis is mainly made via contrast-enhanced CT and/or angiography (34,36,55). As far as the role of gastroscopy in the diagnosis of hemobilia is concerned, blood clots in the duodenum may often be revealed (25,33). There are only two of the nine cases revealing bleeding from Vater's ampulla, as shown in Table 1.…”

Section: Discussionmentioning

confidence: 99%

Severe Blunt Liver Injury Complicated by Delayed Massive Hemobilia in a Toddler: A Case Report and Literature Review

Liu

Sun

et al. 2022

Front. Surg.

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IntroductionUnintentional injuries remain a leading cause of disability among children. Although most of the pediatric patients suffering blunt liver injury can be successfully treated with non-operative therapy, the diagnosis and management of delayed life-threatening hemobilia following severe blunt liver injury, especially in the pediatric population, remain a challenge for clinicians.Case PresentationA previously healthy 2-year-old girl suffered a severe blunt liver injury related to an electric bike, which was inadvertently activated by herself. She initially received non-operative therapy and was in a stable condition in the first 2 weeks. On the 16th and 22nd postinjury days, the patient presented with life-threatening massive hemobilia, which was confirmed via repeat emergent gastroscopy and hepatic arterial angiography. An emergency selective transarterial embolization of the involved branch of the left hepatic artery was successfully performed. The patient recovered uneventfully, and long-term follow-up was needed owing to a mild dilatation of the left intrahepatic bile duct.DiscussionIncidental injury in children should be considered as a major public health issue and preventive measures should be taken to reduce its occurrence. Delayed massive hemobilia after severe blunt liver trauma is rare, and its accurate and timely diagnosis via emergency hepatic arterial angiography and selective angioembolization may allow prompt and optimal management to achieve good outcomes in the pediatric population.

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Section: Discussionmentioning

confidence: 99%

Severe Blunt Liver Injury Complicated by Delayed Massive Hemobilia in a Toddler: A Case Report and Literature Review

Liu

Sun

et al. 2022

Front. Surg.

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“…Seventeen patients (42.5%) presented with abdominal pain, two patients with upper abdominal fullness and pulsation and one patient with general deterioration ( Table 1 ). Of the group of patients presenting with rupture, three cases of mortality (15%) were reported [ 12 , 16 , 17 ], two of which while waiting for endovascular intervention in the hospital at the surgical ward and the third [ 12 ] was due to massive GI re-bleeding weeks following endovascular intervention.…”

Section: To the Editormentioning

confidence: 99%

Giant Pseudoaneurysm of the Splenic Artery: Size/Rupture Correlation

2023

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“…Cases of hepatic artery pseudoaneurysm (HAP)6 are typically encountered secondary to trauma or iatrogenic causes 6–11. However, HAP can be a life-threatening and rare manifestation of the inflammatory vasculitides such as PAN.…”

Section: Introductionmentioning

confidence: 99%

Hepatic artery pseudoaneurysms and hepatic ischaemic injury: a rare complication of polyarteritis nodosa

et al. 2022

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A woman in her 70s presented with months of intermittent fevers, severe fatigue, headaches, abdominal pain and haematuria. She developed acute onset left-sided weakness and was found to have radiographic evidence of right frontal and left parietal intraparenchymal haemorrhages with subarachnoid haemorrhage. She also had markedly elevated liver transaminases with subsequent abdominal MRI that revealed hepatic artery pseudoaneurysms (HAP) requiring embolisation. The case required a multidisciplinary approach consisting of hepatology, interventional radiology and rheumatology. Ultimately, the aetiology was attributed to polyarteritis nodosa (PAN). Through this case report, we highlight HAP as an extremely rare complication of PAN. Although it is a challenging diagnosis to make, it has a favourable response to immunosuppression with high-dose corticosteroids.

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Post-traumatic Pseudoaneurysm of Hepatic Artery: An Unusual Cause of Upper Gastrointestinal Bleeding

Cited by 7 publications

References 8 publications

Severe Blunt Liver Injury Complicated by Delayed Massive Hemobilia in a Toddler: A Case Report and Literature Review

Severe Blunt Liver Injury Complicated by Delayed Massive Hemobilia in a Toddler: A Case Report and Literature Review

Giant Pseudoaneurysm of the Splenic Artery: Size/Rupture Correlation

Hepatic artery pseudoaneurysms and hepatic ischaemic injury: a rare complication of polyarteritis nodosa

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