肝动脉假性动脉瘤(HAA)是一种罕见的闭合性创伤并发症,仅发生在1%的患者中。如果不及早认识和及时管理,它将危及生命,后果恶劣。其他病因包括经颈静脉-肝内门体分流术(TIPS),胰腺炎,胆囊切除术,和肝移植。我们报告了一名38岁妇女在发生机动车事故后的未遂案件。她患有III/IV级肝裂伤(>50%包膜下血肿),表现为上消化道出血(UGIB)。我们的病人在术中紧急治疗,迅速实现止血;然而,术后她继续流血,变得血液动力学不稳定,对大量输血和大剂量质子泵抑制剂无反应。进一步的成像显示HAA,通过介入放射学(IR)进行了线圈栓塞。
Hepatic artery pseudoaneurysm (HAA) is a rare complication of blunt trauma, occurring in only 1% of patients. It is life-threatening with abysmal and atrocious outcomes if not recognized early and managed promptly. Other etiologies include transjugular-intrahepatic portosystemic shunt (TIPS), pancreatitis, cholecystectomy, and liver transplantation. We report a near-miss case in a 38-year-old woman following a motor vehicle accident. She sustained Grade III/IV liver laceration (>50% subcapsular hematoma), presenting with upper gastrointestinal bleeding (UGIB). Our patient was managed emergently intra-operatively, with hemostasis promptly achieved; however, she continued to bleed postoperatively, becoming hemodynamically unstable and unresponsive to both massive blood transfusions and high-dose proton pump inhibitors. Further imaging demonstrated HAA for which coil embolization was carried out by interventional radiology (IR).