Post-traumatic hepatic pseudoaneurysms in children

Background. Post-traumatic hepatic artery pseudoaneurysms are rarely seen i n children. Materials and methods. We retrospectively reviewed the radiologic studies a nd medical records of three patients treated at our institution and reviewe d the literature. The. patients (ages 5-13 years) presented immediately to 2 months after blunt (two patients) and penetrating (one patient) trauma. T he hepatic pseudoaneurysms were discovered during work-up for fever (one pa tient), gastrointestinal bleeding and hyperbilirubinemia (one patient), or widened mediastinum (one patient) on chest radiograph, In two patients, the diagnosis was initially suspected by computed tomography (CT) examination and confirmed by angiography, In the third patient, the diagnosis was made initially by angiography. All three pseudoaneurysms were treated with trans catheter embolization. Results. All three embolizations were initially technically successful. How ever, there was recurrence in one case, in which embolization distal to the neck of the pseudoaneurysms was not technically possible. With conservativ e management, however, the residual lesion demonstrated spontaneous occlusi on by ultrasound (US) at 6 months. Conclusion. This uncommon complication of liver trauma in children can have a delayed presentation, can be clinically unsuspected, and can follow blun t or penetrating trauma. Endovascular embolotherapy is the treatment of cho ice.