Percutaneous angiographic embolization for hepatic arterial hemorrhage
W. H. Wagner, C. J. Lundell and A. J. Donovan
Eight cases of hepatic arterial bleeding are reported. Bleeding in five
instances was consequent to trauma and was either persistent postoperative
(three cases) or delayed with hemobilia (two cases). Bleeding in the other
three cases was from rupture of a subcapsular hematoma of the liver, with
spontaneous hepatic rupture of pregnancy (two cases) and metastatic
melanoma (one case). Angiography demonstrated pseudoaneurysm in six cases,
a hepatic artery to portal venous fistula in one case, and a subcapsular
hematoma in the final case. Percutaneous angiographic embolization
controlled bleeding in seven cases and was not feasible in one case with
tortuosity of the celiac axis. Complications included hepatobiliary
necrosis in one patient and subphrenic abscess in two patients.
Percutaneous angiographic embolization can selectively occlude a branch of
the hepatic artery and is effective in the control of hepatic arterial
bleeding from a variety of causes.
