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CASE REPORT
Year : 2018  |  Volume : 51  |  Issue : 2  |  Page : 83-87

Management of hemodynamically unstable, ruptured multiple hepatic artery pseudoaneurysms by open surgery combined with endovascular embolization


1 Department of Emergency, Division of Trauma, Taipei Veterans General Hospital, Taipei, Taiwan
2 Department of Emergency, Division of Trauma, Taipei Veterans General Hospital; Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
3 Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan

Correspondence Address:
Dr. Meng-Hsuan Chung
Department of Emergency, Division of Trauma, Taipei Veterans General Hospital, No. 201, Section 2, Shihpai Road, Taipei 112
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/fjs.fjs_113_17

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Hepatic artery pseudoaneurysm is a type of visceral artery aneurysm, which may cause life-threatening situation if the diagnosis and treatment are delayed after rupture. Increased clinical awareness and aggressive, definitive management are necessary in obtaining optimal outcomes. In general, surgery is the preferred treatment for extrahepatic lesions, whereas embolization is appropriate for intrahepatic aneurysms. However, exploratory laparotomy for vascular ligation or anastomosis is the only way in emergency if the hemodynamic status is unstable. Since the cases of ruptured pseudoaneurysm in both intra- and extra-hepatic artery is rare, we present a case of ruptured hepatic artery pseudoaneurysms with hemorrhagic shock rescued by surgery to stabilize the patient, followed by angioembolization to manage the multiple hepatic aneurysms and provide a review of the current literature on this topic, focusing on appropriate decision-making under multidisciplinary management.


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