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Management of acute intra-abdominal hemorrhage in ruptured hepatoblastoma with transarterial embolization using calibrated gelfoam particles
Authors:Kin Fen Kevin Fung  Anthony Pak-Yin Liu  Patrick Ho-Yu Chung  Ka King Cheng  Hing Yan Danny Cho  Yee Ling Elaine Kan  Alan Kwok Shing Chiang
Affiliation:1. Department of Radiology, Hong Kong Children's Hospital, Kowloon City, Hong Kong;2. Division of Hematology and Oncology, Department of Pediatrics, Hong Kong Children's Hospital, Kowloon City, Hong Kong;3. Department of Surgery, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong;4. Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Yau Ma Tei, Hong Kong;5. Division of Hematology and Oncology, Department of Pediatrics, Hong Kong Children's Hospital, Kowloon City, Hong Kong

Department of Pediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong

Abstract:
This brief report aims to evaluate the treatment outcome of transarterial embolization in ruptured hepatoblastoma complicated with acute intra-abdominal hemorrhage. Three children (mean age 6 years) with high-risk hepatoblastoma presented with rupture and acute intra-abdominal hemorrhage. In addition to aggressive fluid resuscitation and blood product support, super-selective embolization of the arteries with active bleeding or pseudoaneurysm was performed using calibrated gelfoam particles, with a technical success rate of 100%. Hemodynamic status and hemoglobin level were normalized in all patients within 2 days postembolization. The 30-day survival rate was 100%. No major complication was detected apart from mild elevation of alanine transaminase.
Keywords:acute hemorrhage  embolization  hepatoblastoma  rupture
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