Two Cases of Suspected Liver Compartment Syndrome Treated with Transarterial Embolization

• Published in: Nihon Kyukyu Igakukai Zasshi 2005/07/15, Vol.16(7), pp.301-306
• Main Authors: Hayakawa, Mineji, Gando, Satoshi, Hoshino, Hirokatsu, Uegaki, Shinji, Oshiro, Akiko
• Format: Article
• Language: English
• Subjects: angiography; arterial portal venous shunting; blunt hepatic injury; compartment syndrome; non-operative management
• ISSN: 0915-924X; 1883-3772
• DOI: 10.3893/jjaam.16.301

We herein present two cases suspected of having liver compartment syndrome that were successfully managed with transarterial embolization (TAE). The first patient was a 40-year-old female involved in a car accident. Contrast-enhanced computed tomography (CT) showed a large intraparenchymal hematoma and active hemorrhaging in the hematoma. Transarterial embolization was performed. A hepatofugal portal flow was only detected in the right lobe of the liver, and a normal antegrade flow was observed in the left lobe. The second patient was a 73-year-old man who had fallen down a flight of stairs. Contrast-enhanced CT showed a large intraparenchymal hematoma. On angiography, a small hemorrhage was observed and TAE was performed. A hepatofugal portal flow was detected in the right lobe of the liver. Liver compartment syndrome is defined as intraparenchymal hypertension induced by a large subcapsular hematoma in a patient with blunt hepatic injury. Liver compartment syndrome causes a disruption in the normal liver circulation and may result in either hepatic ischemia or Budd-Chiari syndrome. It is important to prevent an enlargement of the hematoma by applying TAE.