Selective hepatic artery embolization to control massive hepatic hemorrhage after trauma.

Two patients who sustained liver trauma with intrahepatic and intraperitoneal hemorrhage are reported. Selective and subselective arteriography identified the hemorrhagic artery in each case. Transcatheter therapeutic embolization successfully stopped the hemorrhage acutely in one patient and produced almost complete cessation of hemorrhage in the other patient. No further blood replacement was required after the emoblization procedures. Liver function tests were abnormal prior to embolization and gradually improved afterward. Neither patient required surgery, and both were discharged from the hospital. Each patient has remained free of symptoms for 5 and 4 months, respectively. Arteriography offers accurate diagnostic information and therapeutic potential in patients who experience hemorrhage following trauma. In addition, therapeutic embolization may offer decreased morbidity and reduced hospital stay. Successful results of therapeutic embolization depend on awareness of its usefulness and upon rapid mobilization of angiographic and support personnel.