Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Nov 29:5:101686.
doi: 10.1016/j.jaccas.2022.101686. eCollection 2023 Jan 4.

Hemoperitoneum, Hepatic Laceration, and Hepatic Artery Pseudoaneurysm as a Complication of Emergent Pericardiocentesis

Waseem Farooq  1 , Vijay Iyer  1
Affiliations
Case Reports

Hemoperitoneum, Hepatic Laceration, and Hepatic Artery Pseudoaneurysm as a Complication of Emergent Pericardiocentesis

Waseem Farooq et al. JACC Case Rep. .

Abstract

Emergent pericardiocentesis is a potentially life-saving therapeutic procedure. We report a case of hemoperitoneum, a rare but known complication of pericardiocentesis; due to hepatic artery laceration and hepatic artery pseudoaneurysm formation resulting in delayed hemorrhagic shock as a complication of emergent pericardiocentesis. (Level of Difficulty: Intermediate.).

Keywords: CTA, computed tomography angiogram; LA, left atrium; MR, mitral regurgitation; TEE, transesophageal echocardiogram; TEER, transcatheter mitral valve edge-to-edge repair; TTE, transthoracic echocardiogram; hemoperitoneum; hepatic artery laceration; pericardial tamponade; pericardiocentesis.

PubMed Disclaimer

Conflict of interest statement

The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Transthoracic Echocardiogram Subcostal view with new-onset moderate, predominantly anterior, pericardial effusion.
Figure 2
Figure 2
Transthoracic Echocardiogram Parasternal long-axis view showing resolution of pericardial effusion after pericardiocentesis and pigtail catheter placement.
Figure 3
Figure 3
Noncontrast Computed Tomography of Abdomen View showing hemoperitoneum.
Figure 4
Figure 4
Computed Tomography Angiogram of Torso With Intravenous Contrast Material Hyperdense fluid throughout the peritoneal cavity in keeping with hemoperitoneum, stable from earlier noncontrast computed tomography. An indeterminate hypodense lesion (arrow) in left lobe of liver with surrounding hyperemia measuring 1.1 × 1.3 cm. Pericardial drain noted in situ.
Figure 5
Figure 5
Computed Tomography Angiogram With Intravenous Contrast Material Arrow points to the adjacent hyperenhancement on arterial phase representing shunting.
Figure 6
Figure 6
Computed Tomography Angiogram of Torso With Intravenous Contrast Material Enlarged hypoattenuating lesion within left lobe of liver, previously thought to be indeterminate mass, and now favored to represent liver laceration. Arrow points to ill-defined area of hyperattenuation on the arterial phase of the study without definite pooling on delayed phase representing intrahepatic extravasation and pseudoaneurysm formation.
Figure 7
Figure 7
Digital Subtraction Angiography of Left Hepatic Artery Image demonstrating pseudoaneurysm arising from segment III branch of left hepatic artery.
Figure 8
Figure 8
Angiogram Image showing pericardial drain course.
Figure 9
Figure 9
Postembolization Arteriography Image demonstrating complete occlusion of the pseudoaneurysm.
Figure 10
Figure 10
Transthoracic Echocardiogram Apical 4-chamber view demonstrating no pericardial effusion.
Figure 11
Figure 11
Transthoracic Echocardiogram Parasternal long-axis view demonstranting no pericadial effusion.
See this image and copyright information in PMC

Comment in

References

    1. Adler Y., Charron P., Imazio M., et al. 2015 ESC guidelines for the diagnosis and management of pericardial diseases: The task force for the diagnosis and management of pericardial diseases of the European Society of Cardiology (ESC) endorsed by the European Association for Cardio-Thoracic Surgery (EACTS) Eur Heart J. 2015;36 - PubMed
    1. Jareño Martínez S., Bruna Esteban M., Núñez Ronda R., Grifo Albalat I., Fabregat-Andrés Ó Hemoperitoneum due to left inferior phrenic artery injury during pericardiocentesis. Rev Esp Cardiol (Engl Ed) 2015;68:1031–1032. - PubMed

Publication types

LinkOut - more resources