[Non-operative management of a hepatic pseudoaneurysm and a biloma complicating a blunt abdominal trauma].
Hepatic artery pseudoaneurysm and bilioma are rare complications of blunt abdominal trauma in children. We report a case in an 11-year-old patient after a hepatic and splenic blunt trauma following a car accident. The initial evolution was simple with haemodynamic stability. On Day 12, a pseudoaneurysm was discovered on an abdominal magnetic resonance imaging whereas the patient presented a major pain syndrome and an icteric cholestase. Embolisation was realised a few hours later in emergency because of a haemorrhagic shock. On Day 26, an endoscopic retrograde cholangiopancreatography highlighted two bilary leaks: one extrahepatic, the other intrahepatic. The first one was treated with a stent and the second one needed three drains: two peritoneal and one in the biloma. The characteristic of this case relies on the association of two complications. It underlines the need of multidiscipline and non-operative management of pediatric blunt hepatic trauma.
Schott
A
A
Unité de réanimation pédiatrique et néonatale et unité des brûlés pédiatriques, pôle RAUC, CHU Nord, université de la Méditerranée, chemin des Bourrely, 13915 Marseille cedex 20, France.
Michel
F
F
Chaumoître
K
K
Merrot
T
T
Desjeux
A
A
Lagier
P
P
Martin
C
C
D000007:Abdominal Injuries / Q000150:complications*; D017541:Aneurysm, False / Q000209:etiology* / Q000628:therapy*; D001646:Bile; D002648:Child; D006499:Hepatic Artery; D006801:Humans; D008099:Liver / Q000293:injuries*; D008297:Male; D013154:Spleen / Q000293:injuries*; D014949:Wounds, Nonpenetrating / Q000150:complications*