Sugi Tomoyuki, Maruyama Tsunehiko, Nozaki Reiji, Kawahara Masato, Kamoshida Megumi, Narita Sakura, Takaku Hideya, Azuma Kazuaki, Chiba Yoshiro, Oda Tatsuya
Department of Surgery, Mito Saiseikai General Hospital, 3-3-10 Futabadai, Mito, Ibaraki, 311-4198, Japan.
Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
Surg Case Rep. 2023 Jun 27;9(1):120. doi: 10.1186/s40792-023-01704-w.
Hepatic pseudoaneurysm (HPA) is a rare complication that can occur after liver trauma and carries a high risk of rupture. HPA is usually asymptomatic until rupture, so performing routine surveillance of liver trauma patients is important. Most posttraumatic HPA occurs within the first week after injury, so surveillance imaging ~ 7 days postinjury is suggested.
We herein report a 47-year-old man who was diagnosed with asymptomatic HPA 25 days after a knife injury. The patient was transferred to the emergency room after attempting suicide by stabbing himself in his abdomen with a knife. The knife was surgically removed, and the postoperative course was uneventful. Computed tomography (CT) on postoperative day (POD) 12 showed no HPA. However, follow-up CT on POD 25 revealed HPA. The HPA was treated with coil embolization. The patient was discharged with no complications. One year after the injury, the patient had no recurrence or medical problems.
When managing patients with penetrating liver trauma, it is important to note that HPA may not be identifiable on CT early after injury but may still develop later.
肝假性动脉瘤（HPA）是肝外伤后可能发生的一种罕见并发症，破裂风险高。HPA在破裂前通常无症状，因此对肝外伤患者进行常规监测很重要。大多数创伤后HPA发生在受伤后的第一周内，因此建议在受伤后约7天进行监测成像。
我们在此报告一名47岁男性，在刀伤后25天被诊断为无症状HPA。该患者在试图用刀刺伤自己腹部后被送往急诊室。刀被手术取出，术后过程顺利。术后第12天的计算机断层扫描（CT）显示无HPA。然而，术后第25天的随访CT显示有HPA。该HPA采用弹簧圈栓塞治疗。患者出院时无并发症。受伤一年后，患者无复发或其他医疗问题。
在处理穿透性肝外伤患者时，重要的是要注意HPA在受伤后早期的CT上可能无法识别，但仍可能在后期发生。
