Successful Management of Resuscitative Endovascular Balloon Occlusion of the Aorta for Hemorrhagic Shock Due to Ruptured Hepatocellular Carcinoma

A 68-year-old man was transferred to our hospital because of sudden right costal pain with unmeasurable hypotension. Ultrasonography revealed possible hemorrhagic shock due to ruptured hepatocellular carcinoma (HCC). As the patient was not hemodynamically stable after primary treatment, resuscitativ...

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Bibliographic Details
Published in:Internal Medicine 2022/04/15, Vol.61(8), pp.1157-1162
Main Authors: Okada, Haruka, Koike, Yuji, Kishimoto, Shotaro, Mori, Kosuke, Imaki, Shohei, Torii, Ikuo, Komatsu, Hirokazu
Format: Article
Language:English
Subjects:
Aorta
Balloon treatment
Cardiovascular system
Case Report
Computed tomography
Coronary vessels
Embolization
Extravasation
Gelatin
Hemodynamics
Hemorrhage
Hemorrhagic shock
Hepatocellular carcinoma
Hypotension
Internal medicine
Liver cancer
Occlusion
Patients
resuscitative endovascular balloon occlusion of the aorta
transcatheter arterial embolization
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Summary:A 68-year-old man was transferred to our hospital because of sudden right costal pain with unmeasurable hypotension. Ultrasonography revealed possible hemorrhagic shock due to ruptured hepatocellular carcinoma (HCC). As the patient was not hemodynamically stable after primary treatment, resuscitative endovascular balloon occlusion of the aorta (REBOA) was performed, and hemodynamic stability was then achieved. Contrast-enhanced computed tomography confirmed the diagnosis. Transcatheter artery embolization with gelatin sponge particles and coils eliminated the extravasation. The patient was discharged on day 36 post-procedure. Our observations suggest that REBOA may help achieve hemodynamic stability in cases of ruptured HCC.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.8133-21