ABSTRACT
The liver is one of the most commonly injured organ in the abdomen and pelvis. Hepatobiliary trauma is best assessed by contrast-enhanced CT in hemodynamically stable patients. Prompt and accurate diagnosis of hepatobiliary traumatic injuries and associated vascular injuries guides management and allows for successful nonsurgical management of the traumatic injuries. CT can accurately detect and characterize hepatobiliary traumatic injuries and the associated vascular injuries in addition to evaluating delayed complications. We will review hepatobiliary trauma and associated vascular injuries as well as their associated complications.
Subject(s)
Abdominal Injuries , Vascular System Injuries , Wounds, Nonpenetrating , Abdomen , Abdominal Injuries/diagnostic imaging , Contrast Media , Diagnostic Imaging , Humans , Liver/diagnostic imaging , Wounds, Nonpenetrating/diagnostic imagingABSTRACT
Segmental arterial mediolysis (SAM) is a non-inflammatory, non-atherosclerotic vasculopathy mostly involving the abdominal arteries. SAM was recently recognized as a more prevalent aetiology of abdominal pain than initially thought by healthcare providers. It is still a commonly missed diagnosis in patients with recurrent emergency room (ER) visits for abdominal pain. Most published case reports in the past have highlighted catastrophic sequelae such as intra-abdominal haemorrhage requiring surgical intervention. We report a case of SAM where the diagnosis was initially missed. After diagnosis, conservative medical management was offered which led to clinical improvement. LEARNING POINTS: To recognize segmental arterial mediolysis (SAM) as a cause of chronic abdominal pain in the middle-aged and elderly population.To differentiate SAM from inflammatory vasculitis and atherosclerotic conditions.For cases with mild symptoms and haemodynamic stability, conservative management such as early lifestyle modifications, hypertension and hyperlipidaemia control and regular imaging follow-up should be offered.
