Non-operative management of a hepatic pseudoaneurysm and a biloma complicating a blunt abdominal trauma |
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Authors: | Schott A Michel F Chaumoître K Merrot T Desjeux A Lagier P Martin C |
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Institution: | 1. Unité de réanimation pédiatrique et néonatale et unité des brûlés pédiatriques, pôle RAUC, CHU Nord, université de la Méditerranée, chemin des Bourrely, 13915 Marseille cedex 20, France;2. Service de radiologie, pôle Imagerie, CHU Nord, chemin des Bourrely, 13915 Marseille cedex 20, France;3. Service de chirurgie infantile, pôle Parent–Enfant, centre hospitalo-universitaire Nord, université de la Méditerranée, chemin des Bourrely, 13915 Marseille cedex 20, France;4. Service de gastroentérologie, pôle ADOUE, centre hospitalo-universitaire Nord, chemin des Bourrely, 13915 Marseille cedex 20, France |
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Abstract: | Hepatic artery pseudoaneurysm and bilioma are rare complications of blunt abdominal trauma in children. We report a case in an 11-year-old patient after a hepatic and splenic blunt trauma following a car accident. The initial evolution was simple with haemodynamic stability. On Day 12, a pseudoaneurysm was discovered on an abdominal magnetic resonance imaging whereas the patient presented a major pain syndrome and an icteric cholestase. Embolisation was realised a few hours later in emergency because of a haemorrhagic shock. On Day 26, an endoscopic retrograde cholangiopancreatography highlighted two bilary leaks: one extrahepatic, the other intrahepatic. The first one was treated with a stent and the second one needed three drains: two peritoneal and one in the biloma. The characteristic of this case relies on the association of two complications. It underlines the need of multidiscipline and non-operative management of pediatric blunt hepatic trauma. |
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Keywords: | Pseudoanévrisme Enfant Biliome Traumatisme abdominal Traitement conservateur |
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