For the purpose of the study, segment IV
hepatic artery was defined as small branch of one of the main arteries particularly supplying segment IV of the liver.
If selective embolization of the bleeding artery cannot be performed, nonselective embolization of the left or right
hepatic artery may be performed.
It also may take origin from left gastric, middle colic, or left
hepatic artery [11].
Proper
hepatic artery passes anterior to portal vein as it ascends to the epiploic foramen and at porta hepatis branches to right and left.
Busuttil, "
Hepatic artery thrombosis resulting in gas gangrene of the transplanted liver," Surgery, vol.
This case differs in that the CT scan showed dissection of the common
hepatic artery and aneurysms of the common
hepatic artery, splenic artery, and bilateral renal arteries.
We used the Dose Activity Calculator (http://apps01.sirtex.com/smac/) [17, 18] to calculate the appropriate dose and administered a Y-90 dose of 1.36 GBq (37 mCi equivalent) through the right
hepatic artery and a dose of 0.34 GBq through the artery branch for segment VIII (part of the nodule in segment IV was being fed by this branch) (Figures 3(a), 3(b), and 3(c)).
Subsequently, he underwent
hepatic artery angiogram (day 21), which showed critical anastomotic stenosis of the replaced common
hepatic artery that arose directly off the aorta.
A contrast-enhanced CT scan revealed an intimal flap in the celiac trunk and a mural thrombus (Figure 1A) extending to the splenic artery and proximal
hepatic artery (Figure IB) and causing moderate to severe narrowing of the celiac artery (demonstrated by CT angiography) (Figure 2) as well as a thrombosed false lumen, increased attenuation of the surrounding fat, and a segmental splenic infarction (Figure 1).
Pyogenic bacteria can gain access to the liver by direct extension from contiguous organs or through rich dual blood supply provided by the portal vein and
hepatic artery. 1 The clinical presentation of liver abscess is insidious, and fever and right upper quadrant pain are the most common complaints.