Wagner W H, Lundell C J, Donovan A J
Arch Surg. 1985 Nov;120(11):1241-9. doi: 10.1001/archsurg.1985.01390350027007.
Eight cases of hepatic arterial bleeding are reported. Bleeding in five instances was consequent to trauma and was either persistent postoperative (three cases) or delayed with hemobilia (two cases). Bleeding in the other three cases was from rupture of a subcapsular hematoma of the liver, with spontaneous hepatic rupture of pregnancy (two cases) and metastatic melanoma (one case). Angiography demonstrated pseudoaneurysm in six cases, a hepatic artery to portal venous fistula in one case, and a subcapsular hematoma in the final case. Percutaneous angiographic embolization controlled bleeding in seven cases and was not feasible in one case with tortuosity of the celiac axis. Complications included hepatobiliary necrosis in one patient and subphrenic abscess in two patients. Percutaneous angiographic embolization can selectively occlude a branch of the hepatic artery and is effective in the control of hepatic arterial bleeding from a variety of causes.
报告了8例肝动脉出血病例。5例出血由创伤所致，其中3例为术后持续出血，2例为伴有胆道出血的延迟性出血。另外3例出血分别源于肝包膜下血肿破裂，其中2例为妊娠自发性肝破裂，1例为转移性黑色素瘤。血管造影显示6例存在假性动脉瘤，1例存在肝动脉门静脉瘘，最后1例存在包膜下血肿。经皮血管造影栓塞术控制了7例出血，1例因腹腔动脉轴迂曲而无法实施该手术。并发症包括1例患者发生肝胆坏死，2例患者发生膈下脓肿。经皮血管造影栓塞术可选择性地闭塞肝动脉分支，对控制各种原因引起的肝动脉出血有效。
