Pseudoaneurysm of the Proper Hepatic Artery with Duodenal Fistula Appearing as a Late Complication of Blunt Abdominal Trauma

Abou-Jaoudé, Maroun M; Noël, Bernard; Beaudoin, M.; Ghattas, Georges; Lalonde, Lucie; Oliva, Vincent L.

doi:10.1097/00005373-199601000-00024

Cited by 21 publications

(13 citation statements)

References 3 publications

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“…Study methods and patient selection certainly affect this mortality data. In instances of exsanguinating hemorrhage from another source or when hemorrhage cannot be readily controlled, ligation is safe and often necessary [2,5,6].…”

Section: Discussionmentioning

confidence: 99%

“…After hepatic artery ligation, collateral flow from translobar, subcapsular collaterals, phrenicoabdominal, and intercostal arteries reconstitute arterial flow to the liver as early as 24 hours after injury [1][2][3][4][5][6][7]. Furthermore, oxygen extraction can be increased to nearly 100% and appears to be the primary compensatory mechanism after a reduction in hepatic arterial oxygen delivery [8,9].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Hepatic artery transection after blunt trauma: case presentation and review of the literature

Miglietta

Moore

Bernstein

et al. 2006

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hepatic artery transection after blunt trauma: case presentation and review of the literature

Miglietta

Moore

Bernstein

et al. 2006

Journal of Pediatric Surgery

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“…7 Mechanisms associated with traumatic pseudoaneurysm formation include blunt injury or penetrating wounds, orthotopic liver transplantation, and percutaneous transhepatic diagnostic and therapeutic procedures. 8 These most often involve the intrahepatic branches of the hepatic artery (86%), of which the majority (76%) 9 arose from the right branch. This complication after traumatic liver wounds is well described in adults but less so in children.…”

Section: Discussionmentioning

confidence: 99%

Combined Percutaneous and Angiographic Thrombosis of a Traumatic Hepatic Artery Pseudoaneurysm in a Child

Malaisrie

Borge

Glynn

et al. 2005

Journal of Trauma: Injury, Infection &Amp; Critical Care

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“…2), rupture, and associated hemorrhage (Fig. 3), or direct enteric fistulization into the duodenum [32,37,38,39]. Many hepatic PPA are discovered upon evaluation for various reasons including abdominal pain, jaundice, or anemia.…”

Section: Vascular Abnormalitiesmentioning

confidence: 99%

Traumatic injuries: imaging and intervention in post-traumatic complications (delayed intervention)

Goffette

Laterre

2002

Eur Radiol

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The nonoperative management (NOM) of abdominal trauma has gained increasing acceptance over the past decade. This approach has been extended to severe trauma patients previously considered as candidates for surgery. Consequently, the incidence of delayed and uncommonly encountered complications has increased. Causes of delayed complications are multiple and include: (a) abnormal or insufficient injury healing process; (b) retention of necrotic tissue; (c) secondary infection of initially sterile collections; and (d) underestimation of injury severity. The purpose of this review article is to explain the role of various imaging modalities in detecting post-traumatic delayed complications and to highlight the usefulness of minimally invasive techniques, including laparoscopy, biliary endoscopy, therapeutic angiography and image-guided drainage. Subsequent complications, which do not necessarily negatively influence the final outcome, are often predictable, virtually obligatory consequences of the successful NOM of high-grade or complex abdominal injuries. Between 50 and 60% of those patients with grade-IV or grade-V liver or splenic lacerations require some type of interventional treatment; therefore, indiscriminate discharge of patients with solid organ injury managed conservatively may be potentially harmful. As the incidence of complications is higher for more severe grade-IV or grade-V liver, spleen, or kidney injuries, scheduled follow-up CT scans may be rational in this subset of patients to identify potential complications amenable to early application of interventional techniques. Follow-up CT scans are unnecessary in stable adults or children with low-grade injury. Delayed splenic or hepatic rupture is one of the major concerns because this type of complication remains difficult to predict and historically often requires emergent surgery. These ruptures may benefit from NOM, should the same criteria as for primary rupture be respected. Conversely, parenchymatous focal pooling of contrast on initial CT is a good predictor for the development of delayed vascular malformation. In children, as a large part of splenic and hepatic vascular malformations resolve spontaneously, expectant observation may be indicated provided that a strict imaging follow-up is performed until complete disappearance of these lesions. If needed, embolization of parenchymal vascular lesions should be performed as selectively as possible in order to avoid functional parenchyma loss and to reduce the risk of secondary infection of hematoma or ischemic tissue. Technical improvements, such as microcatheter systems and direct percutaneous approach to targeted lesions, have widened the potential for safe endovascular management of acquired vascular malformations. Advantages and disadvantages relative to the different embolic agents are explained. Endoscopic retrograde pancreatography is the chief investigational tool for detecting biliary and pancreatic ducts injuries. The respective roles of endoscopic, percutaneous and surgical approaches...

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Pseudoaneurysm of the Proper Hepatic Artery with Duodenal Fistula Appearing as a Late Complication of Blunt Abdominal Trauma

Cited by 21 publications

References 3 publications

Hepatic artery transection after blunt trauma: case presentation and review of the literature

Hepatic artery transection after blunt trauma: case presentation and review of the literature

Combined Percutaneous and Angiographic Thrombosis of a Traumatic Hepatic Artery Pseudoaneurysm in a Child

Traumatic injuries: imaging and intervention in post-traumatic complications (delayed intervention)

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