title: Isolated hepatic artery thrombosis leading to multiple liver infarcts in a non-transplant patient.
abstract: BACKGROUND
  Isolated hepatic artery thrombosis is an extremely rare condition with only a few cases reported in the literature.
  
  
  METHODS
  A 62-year-old woman presented with a 5-day history of right upper quadrant abdominal pain associated with nausea and vomiting. Physical examination revealed right upper quadrant tenderness. Her initial laboratory work was significant for elevated aspartate aminotransferase and alanine aminotransferase levels (745 and 431 U/L, respectively). A computed tomography of her abdomen showed a thrombus within the hepatic artery, with multiple hepatic infarcts but no evidence of portal vein thrombosis. Hypercoagulability workup was unremarkable; she did not have any evidence of atrial fibrillation on ECG or telemetry. She was treated with subcutaneous low molecular weight heparin. Over the course of her hospitalization, her AST and ALT levels peaked to 2065 and 1217 U/L respectively, and trended down thereafter.
  
  
  CONCLUSIONS
  We believe that our case is unique for 2 reasons: 1) Our patient did not undergo any procedure that may have precipitated hepatic artery thrombosis and 2) Despite the absence of concurrent portal vein thrombosis, she had biochemical and imaging findings of hepatic ischemia.
authors.affiliation: Division of Gatsroenterology and Hepatology, Department of Medicine, John H. Stroger Hospital of Cook County, Chciago, USA.
authors.forename: Tarek
authors.initials: T
authors.lastname: Almouradi
authors.affiliation: Department of Medicine, John H. Stroger Hospital of Cook County, Chicago, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Co
authors.affiliation: Division of Gatsroenterology and Hepatology, Department of Medicine, John H. Stroger Hospital of Cook County, Chicago, USA.
authors.forename: William
authors.initials: W
authors.lastname: Riles
authors.affiliation: Division of Gatsroenterology and Hepatology, Department of Medicine, John H. Stroger Hospital of Cook County, Chicago, USA.
authors.forename: Bashar
authors.initials: B
authors.lastname: Attar
mesh_terms: D000792:Angiography; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D007238:Infarction / Q000175:diagnosis / Q000209:etiology*; D008099:Liver / Q000098:blood supply*; D008875:Middle Aged; D013927:Thrombosis / Q000150:complications* / Q000175:diagnosis; D014057:Tomography, X-Ray Computed