Presentation
Acute abdominal pain.
Patient Data
Irregular ectasia of the distal celiac artery and common hepatic artery with linear filling defect most likely a dissection extending into the proper, right, and left hepatic arteries. Bilobed right hepatic artery pseudoaneurysm in the hepatic hilum has a fistulous communication with the main portal vein at its bifurcation. The left hepatic artery is diminutive and terminates abruptly, likely secondary to the dissection. Nonocclusive thrombus in the central left and right portal veins. Large right and small left hepatic infarcts. Moderate hemorrhage in the left posterior pararenal space with active arterial extravasation along the 11th rib.
The first two angiograms show extensive partially occlusive thrombosis/dissection throughout the dilated common hepatic artery with narrowing of the proximal vessel. Lobular hepatic artery pseudoaneurysm with communication with the portal vein and brisk portal venous filling. The third angiogram was obtained after successful embolization.
Case Discussion
A very unusual case, successfully treated by interventional radiology.
Unable to process the form. Check for errors and try again.