Selective hepatic artery embolization to control massive hepatic hemorrhage after trauma

Area of Science:

• Interventional Radiology
• Hepatobiliary Medicine
• Trauma Surgery

Background:

• Liver trauma can cause significant intrahepatic and intraperitoneal hemorrhage, necessitating prompt and effective management.
• Traditional surgical approaches for liver hemorrhage carry substantial morbidity and mortality risks.
• Arteriography plays a crucial role in diagnosing the source of bleeding in liver trauma.

Observation:

• Two patients with liver trauma and severe hemorrhage underwent selective and subselective arteriography.
• The bleeding artery was precisely identified in both patients using arteriography.
• Transcatheter therapeutic embolization was performed to occlude the identified hemorrhagic vessels.

Findings:

• Acute and near-complete cessation of hemorrhage was achieved in the two patients following embolization.
• Neither patient required subsequent blood transfusions or surgical intervention.
• Liver function tests normalized post-embolization, and patients were discharged with sustained symptom-free recovery.

Implications:

• Transcatheter embolization is a safe and effective minimally invasive treatment for traumatic liver hemorrhage.
• This technique can significantly decrease morbidity, reduce the need for surgery, and shorten hospital stays.
• Widespread adoption requires increased awareness among clinicians and efficient mobilization of interventional radiology teams.