DELAYED RUPTURE OF PSEUDOANEURYSM FOLLOWING BLUNT HEPATIC TRAUMA : A CASE REPORT

Abstract

　　We present a case of hepatic artery pseudoaneurysm that developed following blunt hepatic trauma that had been treated without surgery. The patient was a 12-year-old boy who sustained a bicycle handle-bar injury and was transferred to our hospital. The initial computed tomography (CT) scan showed a complex deep hepatic injury, but there was no apparent vascular injury. The patient was hemodynamically stable and managed without surgery. The clinical course was stable, but a follow-up abdominal CT scan taken on day 8 showed a hepatic artery pseudoaneurysm. The patient went into shock soon after CT was performed. Emergency angiography demonstrated active extravasation. He was treated with transarterial embolization and discharged on day 20. We reevaluated the initial CT scan and noted minor vascular injury. Careful evaluation of initial CT scans to identify minor vascular injury is strongly recommended in patients with complex deep hepatic injuries that have been treated without surgery.