title: Massive Hemorrhage From Multiple Hepatic Artery Aneurysms.
abstract: A 66-year-old man, with an abnormal porta hepatis, consistent with tumor or inflammation, developed massive bleeding from one of numerous hepatic artery aneurysms, and coil embolization achieved control of bleeding. He died of subsequent multisystem organ failure, and the most likely diagnosis was either polyarteritis nodosa or segmental arterial mediolysis. Although the dual hepatic blood supply allows a degree of arterial embolization, this case demonstrates the risks associated with large territory hepatic arterial embolization in the presence of hemodynamic instability. We discuss the management issues related to massive hepatic bleeding when no surgical approach is possible.
authors.affiliation: Department of Surgery, Baystate Vascular Services, Baystate Medical Center, Springfield, MA, USA.
authors.forename: S Lowell
authors.initials: SL
authors.lastname: Kahn
authors.affiliation: Department of Surgery, Baystate Vascular Services, Baystate Medical Center, Springfield, MA, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: McClain
authors.affiliation: Department of Surgery, Baystate Vascular Services, Baystate Medical Center, Springfield, MA, USA jeffrey.kaufmanmd@baystatehealth.org.
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Kaufman
mesh_terms: D000368:Aged; D017542:Aneurysm, Ruptured / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D000072226:Computed Tomography Angiography; D004621:Embolization, Therapeutic; D017809:Fatal Outcome; D006470:Hemorrhage / Q000209:etiology* / Q000628:therapy; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D009102:Multiple Organ Failure / Q000209:etiology; D016896:Treatment Outcome
keywords: embolization; hemorrhage; hepatic aneurysm; visceral artery aneurysm