Hepatic Pseudoaneurysms from Motor Vehicle Accidents Treated with Endovascular Embolisations
N Abdullah, Z Mohamed, Y Yaacob
Hong Kong J Radiol 2014;17:109-13
DOI: 10.12809/hkjr1413196
Objectives: To highlight the incidence of hepatic pseudoaneurysms secondary to motor vehicle accidents and the rate of successful treatment with endovascular embolisation.
Methods: This was a retrospective study performed in a medical centre in Malaysia from January 2009 to January 2012. Cases were identified using the Integrated Reporting and Imaging System of the department and the angiographic unit server. Further details were collected from the patients’ medical records. All patients were followed up by the primary team for at least a year.
Results: There were five cases of hepatic pseudoaneurysms of which two developed arterioportal or arteriovenous shunts. All patients were young adult males with high-grade liver injury. Of these, only one was symptomatic and diagnosed by the presence of fresh blood in the surgical drain; the other four cases were diagnosed by incidental findings on follow-up computed tomography. All the cases were treated successfully with endovascular embolisation: two with glue embolisation and three with coil embolisation. Patients were followed up clinically for 1 year with no significant sequelae.
Conclusion: Hepatic pseudoaneuryms from motor vehicle accidents are a rare complication and, commonly, are incidental findings on follow-up computed tomography. Awareness of this complication is important; treatment with a procedure such as endovascular embolisation can prevent further complications.
中文摘要
血管內栓塞術治療因交通意外事故而發生的肝假性動脈瘤
N Abdullah, Z Mohamed, Y Yaacob
目的：探討因交通意外事故而發生的肝假性動脈瘤的發生率，以及血管內栓塞治療的成功率。
方法：本回顧研究於2009年1月至2012年1月期間於馬來西亞一所醫療中心進行。利用部門的綜合報告和成像系統，以及血管造影裝置找出相關病例。並從病人的病歷中收集進一步的細節。所有患者於術後由初始治療團隊隨訪至少一年。
結果：五例肝假性動脈瘤中，兩例形成了肝動脈-門靜脈或肝動-靜脈短路。所有患者均為重度肝創傷的年輕成年男性。五例當中只有一例出現症狀，因手術引流中出現鮮血而診斷。其餘四例通過隨訪電腦斷層掃描偶然發現而診斷。血管內栓塞術成功治療所有病例；其中兩例使用膠體栓塞，另三例用線圈栓塞。一年臨床隨訪中無明顯後遺症。
結論：因交通意外事故而發生的肝假性動脈瘤是一種罕見的併發症，通常於隨訪電腦斷層掃描中偶然發現。意識到這種併發症很重要，使用如血管內栓塞術的治療方法可防止進一步的併發症。