Hepatic Artery Embolisation in Polytrauma Patients: A Case Series

Abstract

Blunt hepatic injury is quite common in polytrauma cases. In this high-speed era, polytrauma cases are increasing, with serious mortality and morbidity. Authors hereby, described cases of three male patients presenting with blunt abdominal injuries and hepatic lacerations managed successfully with transarterial embolisation with minimal risk. The goal of the present case series was to demonstrate how hepatic artery embolisation can be used to treat blunt hepatic injuries in haemodynamically unstable patients when open surgery is not an option. All patients presenting with blunt trauma to the abdomen were initially screened by Focused Assessment with Sonography for Trauma (FAST), followed by Computed Tomography (CT) angiography of the abdomen where needed, and planned for embolisation of active bleeders or pseudoaneurysms. Transarterial hepatic artery embolisation is used for the management of high- grade liver injuries. Acute post-injury phases with definite evidence of bleeders in CT angiography, and situations where the diagnostic laparotomy is negative but the patient is unstable with low haemoglobin and requires a blood transfusion, are common indications for hepatic artery embolisation. Successful management of high-grade liver injuries often involves a combined angiographic and surgical approach. However, in situations where surgical intervention is not possible, Interventional Radiology (IR) might be the only saviour.