Embolization of an Intrahepatic Portal Vein Branch for Control of a Catastrophic Blunt Hepatic Injury

Abstract

The treatment of hepatic trauma has evolved greatly in recent decades and has grown to involve interventions by interventional radiology, often via angiography. However, there is a paucity of literature on intrahepatic portal vein embolization for hemorrhage control in a stable trauma, let alone unstable patient. Our patient presented with an injury to a branch of his portal vein that was not amenable to surgical control despite multiple attempts. The massive hemorrhage was able to ultimately be controlled via percutaneous embolization of the portal vein branch by interventional radiology without any post-procedure complications. This marks the first published evidence of this procedure being performed in a hemodynamically unstable patient. This case is a proof of concept for portal vein embolization as a reasonable adjunct to managing injuries which are otherwise not amenable to surgical intervention.