Medical Journal of Dr. D.Y. Patil Vidyapeeth (Feb 2024)
A Case Series on Transarterial Embolization in Treatment of Hepatic Artery Pseudoaneurysm (Indian perspective) - our experience in a Single Institute (Centre of Excellence)
Abstract
Purpose: To evaluate the role of transarterial embolization in hepatic artery pseudoaneurysm (HAP) in the Indian population with an analysis of cases done in our hospital in 1 year. Materials and Methods: We searched our database on the computer of the School of Digestive and Liver Disease (SDLD) for cases of HAP within the last 1 year (from May 2021 to April 2022) and then reviewed in detail, examining causes, clinical data, laboratory data, treatment given, and any intervention and if yes then its complications and outcome. We then analyzed all the data from the perspective of the Indian population and compared them with those of previous literature. Result: Eight patients of HAP were found during investigations, who were admitted to SDLD. Another two patients were referred from another department to GI Radiology of SDLD. Causes were identified as blunt trauma abdomen, chronic pancreatitis, liver biopsy, and liver abscess, with blunt trauma being the most common cause. We found two HAPs in the extra-hepatic location, whereas in the rest of the cases, it was intra-hepatic. Among them, the left hepatic artery was involved in one patient and the right hepatic artery was involved in two patients. All the patients were evaluated carefully by both ultrasonography (USG) and tri-phasic computed tomography of the liver. We successfully embolized all of the total 10 patients of HAP in the last 1 year; however, one patient died due to sepsis. Each patient was followed up by USG. Conclusion: HAP is a complication related to blunt injury abdomen, pancreatitis, and post-surgical cases, which should be treated promptly. It can be deadly if left untreated. Successful and prompt intervention can provide good outcomes for these patients and prevent rupture-related complications.
