Upper gastrointestinal hemorrhage from hepatic artery pseudoaneurysm secondary to trauma: a case report.

OBJECTIVE We report a rare but serious case of upper gastrointestinal hemorrhage from hepatic artery pseudoaneurysm. CLINICAL PRESENTATION AND INTERVENTION An 11-year-old child with a history of hepatic trauma 6 months before was admitted for hematemesis and melena. Repeat ultrasound examination showed a 3.6 × 2.8 cm anechoic area with clear border in the right hepatic lobe. Selective angiography confirmed the presence of a pseudoaneurysm of the right hepatic artery. Transcatheter arterial embolization was used to successfully treat the pseudoaneurysm. CONCLUSION This report shows that hepatic artery pseudoaneurysm should be considered as a possible cause of upper gastrointestinal hemorrhage following known hepatic injury. A high index of suspicion, repeated Doppler ultrasound and timely selective angiography are required for diagnosis. Embolotherapy is the treatment of choice.