- Successful Treatment of a Traumatic Hepatic Arterioportal Fistula: A Case Report
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Yun Su Mun, Oh Sang Kwon, Jang Young Lee, Gyeong Nam Park, Hyun Young Han, Min Koo Lee
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J Trauma Inj. 2013;26(1):22-25.
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 Abstract
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- Severe blunt abdominal trauma frequently involves the liver. The development of nonsurgical treatment of liver trauma has led to more frequent appearance of unusual complications. A hepatic arterioportal fistula (APF) is a rare complication of liver trauma. We present a case of traumatic APF in a patient with liver trauma. A 31-year-old male visited our emergency department with pain in the right upper abdomen following a traffic accident. Initial physical exam and abdominal computed tomography (CT) revealed liver laceration with hemoperitoneum. An abdominal CT obtained on day 11 revealed early opacification of the right portal vein on the arterial phase. After we had come to suspect an APF of the liver, its presence was confirmed on angiography. It was subsequently managed by using transcatheter coil embolization. In patients with portal hypertension and no evidence or history of cirrhosis, one should consider an APF as a potential etiology if history of liver biopsy or penetrating trauma exists. In a patient with liver trauma, serial abdominal CT is important for early detection and treatment of an APF.
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Summary
- Ureteral Injury Caused By Blunt Trauma: A Case Report
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Oh Sang Kwon, Yun Su Mun, Seung Hwo Woo, Hyun Young Han, Jung Joo Hwang, Jang Young Lee, Min Koo Lee
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J Trauma Inj. 2012;25(4):291-295.
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Abstract
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- Ureteral trauma is rare, accounting for less than 1% of all urologic traumas. However, a missed ureteral injury can result in significant morbidity and mortality. The purpose of this case presentation is to suggest another method for early detection of ureteral injury in blunt traumatic patient.
A 47-years-old man was injured in pedestrian traffic accident. He undergone 3-phase abdominal CT initially and had had a short-term follow-up simple. We suspected ureteral injury. Our final diagnosis of a ureteral injury was based on follow-up and antegrade pyeloureterography, he underwent emergency surgery.
We detected the ureteral injury early and took a definitive action within 24 hours.
In blunt trauma, if abnormal fluid collection in the perirenal retroperitoneal space is detect, the presence of a ureteral injury should be suspected, so a short-term simple X-ray or abdominal CT, within a few hours after initial abdominal CT, may be useful.
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