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Successful Treatment of Subcapsular Hepatic Hemorrhage Concomitant with Diffuse Arterioportal Shunt by Transcatheter

Emiko Chiba1, Kohei Hamamoto2,3, Maya Oishi3

  • 1Department of Radiology, National Center Hospital, National Center of Neurology and Psychiatry, Japan.

Interventional Radiology (Higashimatsuyama-Shi (Japan)
|October 5, 2022
PubMed

We present a case of subcapsular hepatic hemorrhage with a concomitant diffuse arterioportal shunt successfully treated with transcatheter arterial embolization. An 85-year-old man with duodenal carcinoma developed hemorrhagic shock three days after pancreaticoduodenectomy. Contrast-enhanced computed tomography revealed an extensive subcapsular hepatic hematoma with extravasation. At the same time, diagnostic angiography showed innumerable foci of petechial extravasation from disrupted isolated arteries and the right inferior phrenic artery. In addition, a comorbid diffuse arterioportal shunt in the hematoma area was detected. We performed transcatheter arterial embolization on the peripheral side of the hepatic artery while preserving the proximal portion. Subsequently, the transcatheter arterial embolization for the right inferior phrenic artery was also performed. Complete hemostasis and occlusion of the arterioportal shunt were successful without fulminant liver failure.

Keywords:
arterioportal shuntsubcapsular hepatic hematomatranscatheter arterial embolization

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