Cargando…

Hepatic artery pseudoaneurysm rupture: A case report

Hepatic artery pseudoaneurysms are an uncommon complication of blunt hepatic trauma typically presenting in a delayed fashion. A 40-year-old male presented to a trauma centre after a 6-metre fall from a construction site with multiple injuries including a grade IV liver laceration centred around the...

Descripción completa

Detalles Bibliográficos
Autores principales: Shah, Devansh, Oh, Thomas Young Chul, Pang, Tony CY, Hsu, Jeremy M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10687021/
https://www.ncbi.nlm.nih.gov/pubmed/38035049
http://dx.doi.org/10.1016/j.tcr.2023.100970
_version_ 1785151889954832384
author Shah, Devansh
Oh, Thomas Young Chul
Pang, Tony CY
Hsu, Jeremy M
author_facet Shah, Devansh
Oh, Thomas Young Chul
Pang, Tony CY
Hsu, Jeremy M
author_sort Shah, Devansh
collection PubMed
description Hepatic artery pseudoaneurysms are an uncommon complication of blunt hepatic trauma typically presenting in a delayed fashion. A 40-year-old male presented to a trauma centre after a 6-metre fall from a construction site with multiple injuries including a grade IV liver laceration centred around the porta hepatis. This liver injury was managed non-operatively. On day sixteen of admission, he had a sudden cardiac arrest from haemorrhagic shock with a subsequent CT demonstrating a ruptured extrahepatic proper hepatic artery pseudoaneurysm. Despite laparotomy and vessel repair, he died from pulmonary complications of aspiration pneumonia and acute lung injury associated with massive transfusion. The literature demonstrates conflicting views regarding the utility of repeat CT to detect a pseudoaneurysm in asymptomatic, non-operatively managed patients with blunt hepatic trauma. In particular, the literature does not distinguish the utility of repeat routine CT for intrahepatic and extrahepatic hepatic artery pseudoaneurysm, the latter if which is rarer. Current guidelines recommend against it, but there are observational studies suggesting utility, particularly in high grade (≥IV) liver injury. In patients with a high-grade injury extending to the porta hepatis, repeat imaging should be considered to detect possible pseudoaneurysm.
format Online
Article
Text
id pubmed-10687021
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-106870212023-11-30 Hepatic artery pseudoaneurysm rupture: A case report Shah, Devansh Oh, Thomas Young Chul Pang, Tony CY Hsu, Jeremy M Trauma Case Rep Case Report Hepatic artery pseudoaneurysms are an uncommon complication of blunt hepatic trauma typically presenting in a delayed fashion. A 40-year-old male presented to a trauma centre after a 6-metre fall from a construction site with multiple injuries including a grade IV liver laceration centred around the porta hepatis. This liver injury was managed non-operatively. On day sixteen of admission, he had a sudden cardiac arrest from haemorrhagic shock with a subsequent CT demonstrating a ruptured extrahepatic proper hepatic artery pseudoaneurysm. Despite laparotomy and vessel repair, he died from pulmonary complications of aspiration pneumonia and acute lung injury associated with massive transfusion. The literature demonstrates conflicting views regarding the utility of repeat CT to detect a pseudoaneurysm in asymptomatic, non-operatively managed patients with blunt hepatic trauma. In particular, the literature does not distinguish the utility of repeat routine CT for intrahepatic and extrahepatic hepatic artery pseudoaneurysm, the latter if which is rarer. Current guidelines recommend against it, but there are observational studies suggesting utility, particularly in high grade (≥IV) liver injury. In patients with a high-grade injury extending to the porta hepatis, repeat imaging should be considered to detect possible pseudoaneurysm. Elsevier 2023-11-22 /pmc/articles/PMC10687021/ /pubmed/38035049 http://dx.doi.org/10.1016/j.tcr.2023.100970 Text en © 2023 The Authors. Published by Elsevier Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Shah, Devansh
Oh, Thomas Young Chul
Pang, Tony CY
Hsu, Jeremy M
Hepatic artery pseudoaneurysm rupture: A case report
title Hepatic artery pseudoaneurysm rupture: A case report
title_full Hepatic artery pseudoaneurysm rupture: A case report
title_fullStr Hepatic artery pseudoaneurysm rupture: A case report
title_full_unstemmed Hepatic artery pseudoaneurysm rupture: A case report
title_short Hepatic artery pseudoaneurysm rupture: A case report
title_sort hepatic artery pseudoaneurysm rupture: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10687021/
https://www.ncbi.nlm.nih.gov/pubmed/38035049
http://dx.doi.org/10.1016/j.tcr.2023.100970
work_keys_str_mv AT shahdevansh hepaticarterypseudoaneurysmruptureacasereport
AT ohthomasyoungchul hepaticarterypseudoaneurysmruptureacasereport
AT pangtonycy hepaticarterypseudoaneurysmruptureacasereport
AT hsujeremym hepaticarterypseudoaneurysmruptureacasereport