Hepatic Artery Pseudoaneurysm Rupture: A Case Report and Review of the Literature

Abstract Background Ruptured hepatic artery pseudoaneurysm, a type of visceral artery aneurysm, is a rare condition that is life threatening if not diagnosed and treated rapidly in the emergency department (ED). Patients presenting with this condition require aggressive resuscitation. Endovascular e...

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Bibliographic Details
Published in:The Journal of emergency medicine 2013, Vol.44 (1), p.100-103
Main Authors: Reiter, Dena A., MD, Fischman, Aaron M., MD, Shy, Bradley D., MD
Format: Article
Language:English
Subjects:
Adult
Aneurysm, False - diagnostic imaging
Aneurysm, False - therapy
Aneurysm, Ruptured - diagnostic imaging
Aneurysm, Ruptured - therapy
critical care
embolization
Embolization, Therapeutic
Emergency
Female
hemoperitoneum
Hepatic Artery - diagnostic imaging
Humans
pseudoaneurysm
resuscitation
Rupture, Spontaneous
Tomography, X-Ray Computed
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Summary:Abstract Background Ruptured hepatic artery pseudoaneurysm, a type of visceral artery aneurysm, is a rare condition that is life threatening if not diagnosed and treated rapidly in the emergency department (ED). Patients presenting with this condition require aggressive resuscitation. Endovascular embolization is the first-line treatment option. Objectives We present a case of spontaneously ruptured hepatic artery pseudoaneurysm and provide a review of the current literature on this topic, focusing on appropriate ED management. Case Report A 41-year-old woman with a history of systemic lupus erythematosus and multiple hepatic bilomas presented to the ED in critical condition with sudden onset of severe abdominal pain and hemodynamic instability. She was found to have a ruptured hepatic artery pseudoaneurysm with marked hemoperitoneum on computed tomography angiography. She was aggressively resuscitated and successfully managed via endovascular embolization. Conclusion Ruptured hepatic artery pseudoaneurysm is a life-threatening condition that must be rapidly diagnosed and managed in the ED. Visceral artery aneurysm rupture is a diagnosis that should be considered in any patient presenting to the ED with hemodynamic instability and abdominal pain. Definitive management is with endovascular embolization.
ISSN:0736-4679
2352-5029
DOI:10.1016/j.jemermed.2011.08.021