A Case of Ruptured Hepatoblastoma with Abdominal Compartment Syndrome Successfully Treated by Transcatheter Arterial Embolization via Axillary Artery

Abstract

A four-month-old girl with nausea and pale skin was brought to our hospital. Her blood pressure was unmeasurable. Laboratory analysis revealed an Hb level of 4.7 g/dL and an AFP level of 960,215 ng/mL. CT showed a giant liver tumor and intra-abdominal bleeding. We tried to stabilize her with a transfusion; however, 5 h after she was brought to our hospital, her condition deteriorated, and she went into hemorrhagic shock. We tried to treat her by transcatheter arterial embolization, but we had difficulty in securing the blood flow of the femoral artery and internal carotid artery owing to abdominal compartment syndrome. Then, we found that the axillary artery was palpable and finally we secured the blood flow of the axillary artery and performed a transcatheter arterial embolization. After that, she underwent chemotherapy and hepatectomy. No recurrence has been observed for three years. We consider that the axillary artery is a viable option for securing blood flow in cases of abdominal compartment syndrome.