A Case of a Pseudoaneurysm of the Left Hepatic Artery with an Arterio-Portal Shunt After a Penetrating Hepatic Injury

DOI
  • Umemura Akira
    Department of Critical Care Medicine, Iwate Medical University School of Medicine
  • Kikkawa Tomohiro
    Department of Critical Care Medicine, Iwate Medical University School of Medicine
  • Onodera Chiaki
    Department of Critical Care Medicine, Iwate Medical University School of Medicine
  • Nishinari Yu
    Department of Critical Care Medicine, Iwate Medical University School of Medicine
  • Akitomi Shinji
    Department of Critical Care Medicine, Iwate Medical University School of Medicine
  • Kojika Masahiro
    Department of Critical Care Medicine, Iwate Medical University School of Medicine
  • Inoue Yoshihiro
    Department of Critical Care Medicine, Iwate Medical University School of Medicine
  • Endo Shigeatsu
    Department of Critical Care Medicine, Iwate Medical University School of Medicine

Bibliographic Information

Other Title
  • 鋭的肝外傷後の動門脈シャントを伴う仮性左肝動脈瘤の1例

Search this article

Description

A 53-year-old woman was transported to our clinic by ambulance after suddenly having stabbed herself in the abdomen with a kitchen knife after quarreling with family members at home. The patient had a deep stab wound in her upper abdomen upon arrival, and a grade IIIa hepatic injury (S4) was observed on abdominal CT imaging. The patient was hospitalized for conservative therapy since she responded to initial fluid therapy. Transcatheter arterial embolization (TEA) was performed following the formation of a left hepatic artery pseudoaneurysm, and an arterio-portal (A-P) shunt with the portal vein main trunk via the aneurysm were observed on abdominal CT on day 2. Following TEA, since the A-P shunt was no longer observed and the patient progressed favorably, she was transferred to the department of neuropsychiatry. Hepatic artery aneurysms following hepatic injury are normally pseudoaneurysms that occur as complications in roughly 1% of hepatic injury cases. Although this complication influences the prognosis since it can cause delayed hepatic rupture and biliary tract hemorrhage, several weeks following injury are required until pseudoaneurysm formation. This case was an extremely rare case in which the hepatic pseudoaneurysm formed accompanying A-P shunt soon after that was subsequently treated by TAE, a description of which is reported herein.

Journal

Keywords

Details 詳細情報について

Report a problem

Back to top