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01.12.2014 | Research | Ausgabe 1/2014 Open Access

Journal of Trauma Management & Outcomes 1/2014

Hepatic pseudoaneurysm after traumatic liver injury; is CT follow-up warranted?

Zeitschrift:
Journal of Trauma Management & Outcomes > Ausgabe 1/2014
Autoren:
Lene Østerballe, Frederik Helgstrand, Thomas Axelsen, Jens Hillingsø, Lars Bo Svendsen
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1752-2897-8-18) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

LO: contributed to the study design; collected data; statistical analysis; drafted the manuscript. FH: contributed to the study design; corrected the manuscript; helped with statistical analysis. TA: reviewed the CT scans of the conservatively managed patients. JH: contributed to the study design; corrected the manuscript. LBS: contributed to the study design; corrected the manuscript. All authors read and approved the final manuscript.

Abstract

Introduction

Hepatic pseudoaneurysm (HPA) is a rare complication after liver trauma, yet it is potentially fatal, as it can lead to sudden severe haemorrhage. The risk of developing posttraumatic HPA is one of the arguments for performing follow-up CT of patients with liver injuries. The aim of this study was to investigate the occurrence of HPA post liver trauma.

Methods

A retrospective study from 2000-2010 of conservatively treated patients with blunt liver trauma was performed to investigate the incidence and nature of HPA. After the initial CT scan patients were admitted to the department and if not clinically indicated prior a follow-up CT was performed on day 4-5.

Results

A total of 259 non-operatively managed patients with liver injury were reviewed. 188 had a follow-up CT or US and in 7 patients a HPA was diagnosed. All aneurysms were treated with angiographic embolization and there were no treatment failures. There was no correlation between the severity of the liver injury and development of HPA. 5 out of 7 patients were asymptomatic and would have been discharged without treatment if the protocol did not include a default follow-up CT.

Conclusions

In conclusion, this study shows that HPA is not correlated to the severity of liver injury and it develops in 4% of patients after traumatic liver injury. In order to avoid potentially life-threatening haemorrhage from a post trauma hepatic pseudoaneurysm, it seems appropriate to do follow-up CT as part of the conservative management of blunt and penetrating liver injuries.
Zusatzmaterial
Authors’ original file for figure 1
13032_2014_87_MOESM1_ESM.pdf
Literatur
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Reviewer Acknowledgement

Reviewer acknowledgement 2013