Embolization management of post-traumatic hepatic pseudoaneurysm: A compelling case report

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Trauma Surgery

Background:

• Hepatic artery pseudoaneurysms (HAPs) are uncommon complications of hepatic trauma, occurring in about 1.2% of cases.
• Management strategies for post-traumatic HAPs range from conservative observation to prophylactic embolization, with ongoing debate.
• Minimally invasive approaches are increasingly favored for HAP management.

Observation:

• A 25-year-old patient with Behçet's disease on colchicine presented with symptoms consistent with a ruptured hepatic artery pseudoaneurysm after a traffic accident.
• Clinical presentation included right hypochondriac pain, jaundice, and gastrointestinal hemorrhage (Quincke's triad).
• Computed tomography (CT) confirmed the diagnosis of hepatic artery pseudoaneurysm.

Findings:

• Successful treatment was achieved with percutaneous embolization, a minimally invasive radiological procedure.
• Angioscan (CT angiography) proved to be a reliable diagnostic tool for identifying the pseudoaneurysm.
• The case underscores the efficacy of interventional radiology in managing complex vascular injuries.

Implications:

• Percutaneous embolization is the current primary treatment modality for hepatic artery pseudoaneurysms.
• A transhepatic approach serves as a viable alternative when conventional embolization techniques fail.
• Radiologically guided, minimally invasive interventions represent the standard of care for post-traumatic HAPs.