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Delayed hemorrhage following transcatheter arterial embolization for blunt hepatic injury
A Hagiwara1, T Yukioka, S Shimazaki
1Department of CCM and Traumatology, Kyorin University Hospital, Tokyo, Japan.
This is the first report of delayed hemorrhage (21 days after the injury) following transcatheter arterial embolization (TAE) for severe hepatic injury. The first TAE was performed about 2 h after admission on a 21-year-old man with severe blunt hepatic injury. Three bilomas were detected by cholescintigraphy 19 days later. The patient's status had been eventless until the occurrence of a delayed hemorrhage with hypotension. Angiography was repeated and three pseudoaneurysms were detected in the same areas as the bilomas. With repeated TAE, pseudoaneurysms disappeared and hemorrhage could be controlled. Intrahepatic biloma may be related to pseudoaneurysms and delayed hemorrhage in severe hepatic injury.
This is the first report of delayed hemorrhage (21 days after the injury) following transcatheter arterial embolization (TAE) for severe hepatic injury. The first TAE was performed about 2 h after admission on a 21-year-old man with severe blunt hepatic injury. Three bilomas were detected by cholescintigraphy 19 days later. The patient's status had been eventless until the occurrence of a delayed hemorrhage with hypotension. Angiography was repeated and three pseudoaneurysms were detected in the same areas as the bilomas. With repeated TAE, pseudoaneurysms disappeared and hemorrhage could be controlled. Intrahepatic biloma may be related to pseudoaneurysms and delayed hemorrhage in severe hepatic injury.