Upper Gastrointestinal Hemorrhage from Hepatic Artery Pseudoaneurysm Secondary to Trauma: A Case Report

Abstract

Objective: We report a rare but serious case of upper gastrointestinal hemorrhage from hepatic artery pseudoaneurysm. Clinical Presentation and Intervention: An 11-year-old child with a history of hepatic trauma 6 months before was admitted for hematemesis and melena. Repeat ultrasound examination showed a 3.6 × 2.8 cm anechoic area with clear border in the right hepatic lobe. Selective angiography confirmed the presence of a pseudoaneurysm of the right hepatic artery. Transcatheter arterial embolization was used to successfully treat the pseudoaneurysm. Conclusion: This report shows that hepatic artery pseudoaneurysm should be considered as a possible cause of upper gastrointestinal hemorrhagefollowing known hepatic injury. A high index of suspicion, repeated Doppler ultrasound and timely selective angiography are required for diagnosis. Embolotherapy is the treatment of choice.

Intrahepatic Artery Pseudoaneurysm as a Delayed Presentation of Blunt Abdominal Trauma

“…Hepatic artery pseudoaneurysm (HAP) is a rare complication of liver injuries following blunt abdominal trauma (1)(2)(3). HAP rupture is the most dangerous and fatal obstacle, which usually presents itself as vague abdominal discomfort, gastrointestinal bleeding, and hemobilia (4)(5)(6).…”

Hepatic Pseudoaneurysms from Motor Vehicle Accidents Treated with Endovascular Embolisations

“…Published data show that pseudoaneurysm may be diagnosed from 3 days to 6 months post-trauma. [3][4][5]9,10 In our study, pseudoaneurysms were diagnosed between 10 and 34 days post-trauma. Identification of an arterioportal fistula (hepatic arteryportal vein) is important to avoid the late complication of life-threatening portal hypertension and formation of varices.…”

Case report of hepatic artery dissection secondary to hepatic artery pseudoaneurysm after living donor liver transplantation

“…This case is significant because, to the best of our knowledge, HA dissection secondary to HAP accompanied by thrombosis and collateral circulation after LDLT has been rarely reported in the English literature. Although uncommon, HAP and HA dissection have a high morbidity and mortality, and early diagnosis and treatment are important [ 6 – 8 , 15 – 17 ].…”

“…Very few studies have reported HAP or HA dissection [ 6 – 8 , 15 – 17 ]. In this paper, we report a case of HA dissection secondary to HAP and accompanied by thrombosis and collateral circulation as well as secondary biliary complications after LDLT, which was diagnosed and followed for one year by ultrasound.…”