Patel M S, Shetty V, Shelake A, Deshpande A A
Department of General Surgery, Seth G.S. Medical College and K.E.M. Hospital, Parel, Mumbai, Maharashtra, India.
J Postgrad Med. 2018 Oct-Dec;64(4):250-252. doi: 10.4103/jpgm.JPGM_81_18.
Visceral artery aneurysms (VAA) are an uncommon but well recognized condition. Hepatic artery aneurysms (HAA) represent 14-20% of all visceral artery aneurysms. Post traumatic hepatic artery pseudoaneurysm is an uncommon delayed complication of blunt liver trauma. Here we present a case of a 27 year old male with blunt abdominal trauma who developed a post traumatic pseudoaneurysm of the hepatic artery just proximal to its bifurcation into the left and right branches. The pseudoaneurysm ruptured within 12 hours of injury and he required double ligation of the hepatic artery as well as right and left hepatic arteries . However, the bleeding continued through the retrograde flow from the gastroduodenal artery and hence, ligation of gastrodudenal artery was also done. The decision of complete devasularisation of liver was taken as an emergency lifesaving procedure. The patient recovered and was discharged without sequel.
内脏动脉瘤(VAA)是一种罕见但已被充分认识的疾病。肝动脉瘤(HAA)占所有内脏动脉瘤的14% - 20%。创伤后肝动脉假性动脉瘤是钝性肝损伤罕见的延迟并发症。在此,我们报告一例27岁男性钝性腹部创伤患者,其在肝动脉分叉为左右分支的近端发生了创伤后肝动脉假性动脉瘤。该假性动脉瘤在受伤后12小时内破裂,患者需要对肝动脉以及左右肝动脉进行双重结扎。然而,出血通过来自胃十二指肠动脉的逆行血流持续,因此,也对胃十二指肠动脉进行了结扎。作为紧急救命措施,决定对肝脏进行完全去血管化。患者康复并出院,无后遗症。