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Segmental arterial mediolysis of hepatic artery

Case contributed by Thomas Snow
Diagnosis almost certain

Presentation

Spontaneous bleeding into the porta hepatis and retroperitoneum.

Patient Data

Age: 70 years
Gender: Female

Digital subtraction angiography shows aneurysm, stenosis, and partial thrombosis of the hepatic artery. The gastroduodenal artery has been occluded by coils. The intrahepatic branches of the hepatic artery are attenuated and irregular.

The gastroduodenal artery has been occluded by coils. The hepatic artery has been occluded with an Amplatzer device (Aga Medical). Contrast angiograms showed occlusion of the affected segment. A modest decrease in hepatic function was detected after a few days.

Case Discussion

Case of hepatic artery segmental arterial mediolysis presenting with spontaneous porta hepatis haemorrhage and treated with Amplatzer device.  

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