Skip to main content
Log in

Arterial Embolization for Hemorrhage Caused by Hepatic Arterial Injury

  • REVIEW ARTICLE
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Fewer than 10% of patients with major liver trauma have life-threatening bleeding. Laparoscopic operations, endoscopic procedures, and percutaneous interventions such as drainages, vascular or tumor sclerosis, biopsies, and transjugular intrahepatic portocaval shunt (TIPS) have increased the number of iatrogenic vascular and bile duct injuries. Due to its therapeutic success, arterial embolization (AE) has become the standard treatment for late complications of hepatic injury. In some cases, this procedure may be used as the first approach on accidental or iatrogenic arterial trauma and in several hepatic arterial diseases. The result of this method depends on physician experience, size of the wound, and stability of the patient. Persistent hemorrhage and rebleeding may be treated with a new AE or an operation. Precise indication and a correctly performed AE are key factors for a successful treatment. Rebleeding episodes are a rare occurrence, which may be treated with AE as well.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Richardson JD, Franklin GA, Lukan JK (2000) Evolution in the management of hepatic trauma. Ann Surg 232:324–330

    Article  Google Scholar 

  2. Hagiwara A, Yukioka T, Ohta S (1997) Nonsurgical management of patients with blunt hepatic injury: efficacy of transcatheter arterial embolization. Am J Roentgenol 169:1151–1156

    CAS  Google Scholar 

  3. Harper HC 3rd, Maull KI (2000) Transcatheter arterial embolization in blunt hepatic trauma. South Med J 93:663–665

    PubMed  Google Scholar 

  4. Ohtsuka Y, Iwasaki K, Okazumi S (2003) Management of blunt hepatic injury in children. Pediatr Surg Int 19:29–34

    PubMed  CAS  Google Scholar 

  5. Chigot V, Lallier M, Alvarez F, Dubois J (1996) Hepatic artery pseudoaneurysm following laparoscopic cholecystectomy. Pediatr Radiol 33:24–26

    Article  Google Scholar 

  6. Czerniak A, Thompson JN, Hemingway AP (1988) Hemobilia. Arch Surg 123:718–721

    PubMed  CAS  Google Scholar 

  7. Hermine C, Ernst O, Delemazure O, Sergent G (1996) Arterial complications of percutaneous transhepatic biliary drainage. Cardiovasc Intervent Radiol 19:160–164

    PubMed  Google Scholar 

  8. Lumsden AB, Allen RC, Sreeram S, Atta H, Salam A (1993) Hepatic arterioportal fistula. Am Surg 59: 722–726

    PubMed  CAS  Google Scholar 

  9. Nicholson T, Travis S, Ettles D (1999) Hepatic angiography and embolization for hemobilia following laparoscopic cholecystectomy. Cardiovasc Intervent Radiol 22:20–24

    Article  PubMed  CAS  Google Scholar 

  10. Villasante JM, Alvarez-Rodriguez RE, Hernandez-Ortiz J (1977) Management of postbiopsy hemobilia with selective arterial embolization. Am J Roentgenol 128:668–671

    Google Scholar 

  11. Wagner WH, Lundell CJ, Donovan AJ (1985) Percutaneous angiographic embolization for hepatic arterial hemorrhage. Arch Surg 120:1241–1249

    PubMed  CAS  Google Scholar 

  12. Jander HP, Laws HL, Kogutt MS, Mihas AA (1977) Emergency embolization in blunt hepatic trauma. Am J Roentgenol 129:249–252

    CAS  Google Scholar 

  13. Walter JF, Paaso BT, Cannon WB (1976) Successful transcatheter embolic control of massive hematobilia secondary to liver biopsy. Am J Roentgenol 127:847–849

    CAS  Google Scholar 

  14. Bloechle C, Izbicki JR, Rashed MYT (1994) Hemobilia. Am J Gastroenterol 89:1537–1540

    PubMed  CAS  Google Scholar 

  15. Forlee MV, Krige JE, Welman CJ, Beningfield SJ (2004) Haemobilia after penetrating and blunt liver injury. Injury 35:23–28

    Article  PubMed  CAS  Google Scholar 

  16. Greco L, Francioso G, Pratichizzo A, Testini M, Impedovo G, Ettorre GC (2003) Arterial embolization in the treatment of severe blunt hepatic trauma. Hepatogastroenterology 50:746–749

    PubMed  Google Scholar 

  17. Hasegawa S, Moriwaki Y, Uchida K, Kosuge T, Yamamoto T, Sugiyama M (2004) Biliary leakage due to a rapidly growing post-traumatic hepatic artery pseudoaneurysm. Hepatogastroenterology 51:434–435

    PubMed  Google Scholar 

  18. Hidalgo F, Narvaez JA, Rene M, Dominguez J, Sancho C, Montanya X (1995) Treatment of hemobilia with selective artery embolization. J Vasc Interv Radiol 6:793–798

    Article  PubMed  CAS  Google Scholar 

  19. Mathisen DJ, Athanasoulis CA, Malt RA (1982) Preservation of arterial flow to the liver. Ann Surg 196:400–411

    Article  PubMed  CAS  Google Scholar 

  20. Moodley J, Singh B, Lalloo S, Pershad S, Robbs JV (2001) Non-operative management of haemobolia. Br J Surg 88:1073–1076

    Article  PubMed  CAS  Google Scholar 

  21. Roche A, Doyon D, Harry G, Benozio M (1978) L’embolisation arterielle therapeutique en hemobilie. J Radiol Electrol Med Nucl 59:191–196

    PubMed  CAS  Google Scholar 

  22. Vaughan R, Rosch J, Keller FS, Antonovic R (1984) Treatment of hemobilia by transcatheter vascular occlusion. Eur J Radiol 4:183–189

    PubMed  CAS  Google Scholar 

  23. Kadir S, Athanasoulis CA, Ring EJ, Greenfield A (1980) Transcatheter embolization of intrahepatic arterial aneurysms. Radiology 134:335–339

    PubMed  CAS  Google Scholar 

  24. Stambo GW, Guiney MJ, Cannella XF, Germain BF (2004) Coil embolization of multiple hepatic artery aneurysms in a patient with undiagnosed polyarteritis nodosa. J Vasc Surg 39:1122–1124

    Article  PubMed  Google Scholar 

  25. Ciraulo DL, Luk S, Palter M, Cowell V, Welch J, Cortes V, Orlando R, Banever T, Jacobs L (1998) Selective hepatic arterial embolization of grade IV and V blunt hepatic injuries: an extension of resuscitation in the nonoperative management of traumatic hepatic injuries. J Trauma 45:353–359

    PubMed  CAS  Google Scholar 

  26. Hagiwara A, Murata A, Matsuda T, Matsuda H, Shimazaki S (2002) The efficacy and limitations of transarterial embolization for severe hepatic injury. J Trauma 52:1091–1096

    Article  PubMed  Google Scholar 

  27. Harry G, Roche A, Weingarten A, Doyon D (1977) L’embolisation arterielle hepatique. Med Chir Dig 6:193–196

    PubMed  CAS  Google Scholar 

  28. Shiono T, Yoshikawa K, Hisamatsu K, Takenaka E (1993) Efficacy of emulsion containing Gd-DTPA and lipiodol in hepatic transcatheter arterial embolization. Radiat-Med 11:187–190

    PubMed  CAS  Google Scholar 

  29. Yao DC, Jeffrey RB Jr, Mirvis SE (2002) Using contrast-enhanced helical CT to visualize arterial extravasation after blunt abdominal trauma. Am J Roentgenol 178:17–20

    Google Scholar 

  30. Huang XQ, Huang ZQ, Duan WD, Zhou NX, Feng YQ (2002) Severe biliary complications after hepatic artery embolization. World J Gastroenterol 8:119–123

    PubMed  Google Scholar 

  31. Gorich J, Rilinger N, Brado M (1999) Non-operative management of arterial liver hemorrhages. Eur Radiol 9:85–88

    Article  PubMed  CAS  Google Scholar 

  32. Regensberg C, Richard JP, Doyon D, Frileux C (1973) L’embolisation des artères hépatiques. Nouv Presse Méd 2:1717–1718

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A Petroianu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Petroianu, A. Arterial Embolization for Hemorrhage Caused by Hepatic Arterial Injury. Dig Dis Sci 52, 2478–2481 (2007). https://doi.org/10.1007/s10620-006-9704-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-006-9704-1

Keywords

Navigation