A case of post-traumatic pseudoaneurysm of the hepatic artery treated with endovascular embolization and review of the literature

Ann Ital Chir. 2021 Sep 27:10:S2239253X21036161.

Abstract

Aim: The pseudoaneurysm of the hepatic artery (HAP) is mainly associated with liver trauma. Post-traumatic HAP is usually asymptomatic and found at imaging follow-up. Its detection warrants correction, irrespective of size or symptoms.

Material of study: We report a case of post-traumatic liver pseudoaneurysm treated with endovascular embolization. An 80-year-old man developed pseudoaneurysm of the S6 branch of the hepatic artery, 14 days after a motorcycle accident.

Results: The patient was treated with radiological embolization of the pseudoaneurysm, which completely disappeared. After the intervention, the patient developed acute anemia and leukocytosis. At discharge, the white blood cell count was normal, as well as hemoglobin and bilirubin concentrations.

Discussion: Treatment options include endovascular embolization, ultrasound-guided thrombin injection, placement of an angiographic stent, surgical ligation, and surgical resection.

Key words: Aneurysm, Pseudoaneurysm, Abdominal trauma, Liver, Post-Traumatic.

Il riscontro di pseudoaneurisma dell’arteria epatica, dopo trauma epatico è raro (1% dei casi). Viene preso in considerazione un caso di trauma addominale in incidente della strada (caduta da motociclo). La comparsa dello pseudoaneurisma si è evidenziata, all’esame TC, dodici giorni dal trauma. Si è scelto il trattamento mediante embolizzazione radiologica. Dopo l’intervento è stata riscontrata anemia e temporanea leucocitosi. Vengono analizzati i possibili sintomi e discusse le varie tecniche interventistiche e chirurgiche, nonché la revisione della letteratura sull’argomento.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged, 80 and over
  • Aneurysm, False* / diagnostic imaging
  • Aneurysm, False* / etiology
  • Aneurysm, False* / therapy
  • Embolization, Therapeutic*
  • Hepatic Artery / diagnostic imaging
  • Humans
  • Male
  • Stents
  • Ultrasonography