Hepatic Pseudoaneurysm Incidence After Liver Trauma

Area of Science:

• Trauma Surgery
• Vascular Surgery
• Diagnostic Imaging

Background:

• Posttraumatic hepatic artery pseudoaneurysm is a severe complication following liver trauma.
• Increased use of computed tomography (CT) aids in identifying these complications.
• Understanding the incidence of pseudoaneurysms is vital for patient management.

Purpose of the Study:

• To determine the incidence of hepatic artery pseudoaneurysm after traumatic liver injury.
• To correlate pseudoaneurysm development with liver injury severity.
• To evaluate the timing and presentation of posttraumatic hepatic pseudoaneurysms.

Main Methods:

• Retrospective review of patients with liver injuries at a Level 1 trauma center (2012-2016).
• Data extraction from trauma registry and chart review, including injury characteristics and complications.
• Analysis of 634 hepatic injuries, categorizing by AAST grade.

Main Results:

• Eighteen hepatic pseudoaneurysms were identified among 634 hepatic injuries.
• Incidence increased with injury grade: Grade III (1.8%), Grade IV (6.5%), Grade V (17.3%).
• Pseudoaneurysms were identified at a median of 6.5 days post-injury; some were asymptomatic on surveillance CT angiography.

Conclusions:

• Hepatic artery pseudoaneurysm incidence correlates directly with liver injury grade.
• Aggressive surveillance with CT angiography 5-7 days post-injury is recommended for high-grade (IV and V) liver injuries.
• Early detection is critical, as symptomatic pseudoaneurysms can lead to hemorrhagic shock and death.