Tri Tran Thanh, Thach Pham Ngoc, Duy Ho Phi, Thuan Luu-Nguyen An, Kiet Phan Tuan, Duc Nguyen Minh
Department of General Surgery, Children's Hospital 2, Ho Chi Minh city, Vietnam.
Department of Radiology, Pham Ngoc Thach University of Medicine, 2 Duong Quang Trung Ward 12 District 10, Ho Chi Minh City 700000, Viet Nam.
Radiol Case Rep. 2022 Dec 22;18(3):895-898. doi: 10.1016/j.radcr.2022.11.078. eCollection 2023 Mar.
Although post-traumatic intrahepatic pseudoaneurysms are rare in adults and even more uncommon in children, this serious complication can result in life-threatening bleeding. Most case studies have recommended surgical or endovascular interventions for preventing rupture or managing the bleeding from a ruptured intrahepatic pseudoaneurysm. Some studies also reported pseudoaneurysms could resolve without intervention and advised conservative therapy. In this case study, we describe a 19-month-old boy diagnosed with an intrahepatic pseudoaneurysm, upper gastrointestinal bleeding from the biliary tract, and hematoma infection. The patient received successful conservative treatment. After 36 days, the patient was discharged without signs of gastrointestinal bleeding and the steady shrinkage of the hematoma surrounding the pseudoaneurysm. The pseudoaneurysm and hematoma vanished at follow-up 18 months after the trauma. Conservative treatment may be considered a viable option, particularly for cases of post-traumatic intrahepatic pseudoaneurysms in children.
尽管创伤后肝内假性动脉瘤在成人中罕见,在儿童中更为少见,但这种严重并发症可导致危及生命的出血。大多数病例研究推荐采用手术或血管内介入治疗来预防破裂或处理肝内破裂假性动脉瘤的出血。一些研究还报告假性动脉瘤可在未干预的情况下自行消退,并建议采用保守治疗。在本病例研究中,我们描述了一名19个月大的男孩,他被诊断为肝内假性动脉瘤、胆道上消化道出血和血肿感染。该患者接受了成功的保守治疗。36天后,患者出院,无胃肠道出血迹象,假性动脉瘤周围血肿持续缩小。创伤后18个月随访时,假性动脉瘤和血肿消失。保守治疗可能是一种可行的选择,特别是对于儿童创伤后肝内假性动脉瘤病例。