title: Multifactorial aetiology of hepatic infarction: a case report with literature review.
abstract: The rarity of hepatic infarction has been explained by the protection from ischaemia provided by the double arterial and portal inflow. Hepatic infarction hence should require the association of multiple factors jeopardizing compensatory mechanisms. We report on a case of hepatic infarction related to combined hepatic arterial and portal venous thrombosis after a blunt abdominal trauma, a previously unreported cause of hepatic infarction. Several causes of vascular impairment were present: shear stress injury due to the trauma, protein C deficiency, type II diabetes and administration of glibenclamide, a splanchnic vasoconstrictor agent. There was repermeation of the portal vein and hepatic artery following anticoagulation therapy. Because hepatic infarction is usually explained by the concurrence of several factors impairing the hepatic blood supply, an extensive search for associated conditions is necessary even when a conspicuous cause is present.
authors.affiliation: Service d'Hépatologie and INSERM U481, Hôpital Beaujon, Clichy, France.
authors.forename: Sven
authors.initials: S
authors.lastname: Francque
authors.forename: Bertrand
authors.initials: B
authors.lastname: Condat
authors.forename: Tarik
authors.initials: T
authors.lastname: Asselah
authors.forename: Valérie
authors.initials: V
authors.lastname: Vilgrain
authors.forename: François
authors.initials: F
authors.lastname: Durand
authors.forename: Richard
authors.initials: R
authors.lastname: Moreau
authors.forename: Dominique
authors.initials: D
authors.lastname: Valla
mesh_terms: D000007:Abdominal Injuries / Q000150:complications; D000368:Aged; D006499:Hepatic Artery; D006801:Humans; D007238:Infarction / Q000209:etiology*; D008099:Liver / Q000098:blood supply* / Q000000981:diagnostic imaging; D008297:Male; D011169:Portal Vein; D011859:Radiography; D013927:Thrombosis / Q000150:complications; D014949:Wounds, Nonpenetrating / Q000150:complications