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Mann AJ, Rueda M, Azar F, Ramseyer M, Lottenberg L, Borrego R. Persistent pseudoaneurysm after non-operative management of a Grade 4 liver injury. Trauma Case Rep 2023; 48:100946. [PMID: 37822491 PMCID: PMC10562760 DOI: 10.1016/j.tcr.2023.100946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2023] [Indexed: 10/13/2023] Open
Abstract
A hepatic pseudoaneurysm (HPA) after blunt or penetrating liver injury is an unusual but potentially lethal complication that can develop from an injured hepatic artery branch [1-5]. Endovascular intervention with coil embolization to treat HPA is a safe and effective method and has become the standard first-line treatment, with a success rate achieving 70-100 % [13,14,15]. Infrequently the pseudoaneurysm is fed by collateral vessels and endovascular intervention may be unsuccessful. Other minimally invasive treatment options that can be considered include image guided percutaneous thrombin injection, endovascular placement of covered stents and injection of liquid agents such as fibrin glue [10,11]. We present a case of a young female who developed a post-traumatic persistent hepatic pseudoaneurysm requiring a total of nine interventions, including six endovascular interventions with angiography, three endoscopic procedures for bleeding, one percutaneous injection, and two re-admissions to the hospital. Although she avoided initial operative management, her three-month hospital course can be considered a failure of conservative management of blunt hepatic trauma due to the accrued health care costs and resources. The literature on the management of persistent pseudoaneurysm is limited. The decision to treat a persistent HPA that are found incidentally and stable in size needs further investigation.
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Affiliation(s)
| | - Mario Rueda
- Florida Atlantic University, 777 Glades Rd, Boca Raton, FL 33431, United States of America
- St. Mary's Medical Center, 901 45th St, West Palm Beach, FL 33407, United States of America
| | - Faris Azar
- Florida Atlantic University, 777 Glades Rd, Boca Raton, FL 33431, United States of America
- St. Mary's Medical Center, 901 45th St, West Palm Beach, FL 33407, United States of America
| | - Matthew Ramseyer
- Florida Atlantic University, 777 Glades Rd, Boca Raton, FL 33431, United States of America
- St. Mary's Medical Center, 901 45th St, West Palm Beach, FL 33407, United States of America
| | - Lawrence Lottenberg
- Florida Atlantic University, 777 Glades Rd, Boca Raton, FL 33431, United States of America
- St. Mary's Medical Center, 901 45th St, West Palm Beach, FL 33407, United States of America
| | - Robert Borrego
- Florida Atlantic University, 777 Glades Rd, Boca Raton, FL 33431, United States of America
- St. Mary's Medical Center, 901 45th St, West Palm Beach, FL 33407, United States of America
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Alexander CM, Ramseyer M, Beatty JS. Missed Extravasation Injury from Peripheral Infusion of Norepinephrine Resulting in Forearm Compartment Syndrome and Amputation. Am Surg 2016. [DOI: 10.1177/000313481608200713] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Alexander CM, Ramseyer M, Beatty JS. Missed Extravasation Injury from Peripheral Infusion of Norepinephrine Resulting in Forearm Compartment Syndrome and Amputation. Am Surg 2016; 82:e162-e163. [PMID: 27457846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Urech E, Ramseyer M, Pache D. Examen radiologique systématique des adénites tuberculeuses primaires du cou. Respiration 2009. [DOI: 10.1159/000191855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Ramseyer M, Bourquin J. [Mammography]. Rev Med Suisse Romande 1976; 96:881-6. [PMID: 1005992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Buffat JD, Ramseyer M, Muller M. [Small cell tumor: anaplastic carcinoma or malignant lymphoma of the thyroid gland and the stomach]. Praxis 1968; 57:520-523. [PMID: 5756176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Mamie M, Ramseyer M. [The problem of non-calculous cholecystitis]. Praxis 1965; 54:834-840. [PMID: 5897444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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