2014 Volume 28 Issue 3 Pages 277-281
A 6-year-old boy who fell off his bicycle and sustained contusional injury of the upper abdomen caused by the impact of the bicycle handlebar was brought to our hospital. On arrival, he was alert, the blood pressure was 104/69 mmHg, and the heart rate was 87/min. Dynamic CT revealed crush injury of the right hepatic lobe with hepatic artery pseudoaneurysm and bleeding in the abdominal cavity. Grade IIIa liver trauma (Classification of Organ Injury, JAST 2008) was diagnosed, and transcatheter arterial embolization (TAE) was planned because the cardiovascular status was stable. The patient could be maintained in the resting position without sedative medication. As extravasation from the replaced right hepatic artery A8 was noted, intra-arterial embolization was performed. The patient had an uneventful postoperative course and was discharged on day 14. Liver injury caused by impact of a bicycle handlebar in a child is uncommon, but can result even from a relatively small external linear force. Such impact may give rise to the formation of a pseudoaneurysm, despite a stable circulatory status. The present results indicate that TAE is an effective treatment modality in such cases.
