Causes of hepatic artery occlusion include thrombosis (eg, due to hypercoagulability disorders, severe arteriosclerosis Atherosclerosis Atherosclerosis is characterized by patchy intimal plaques (atheromas) that encroach on the lumen of medium-sized and large arteries; the plaques contain lipids, inflammatory cells, smooth muscle... read more , or vasculitis Overview of Vasculitis Vasculitis is inflammation of blood vessels, often with ischemia, necrosis, and organ inflammation. Vasculitis can affect any blood vessel—arteries, arterioles, veins, venules, or capillaries... read more ), emboli (eg, due to endocarditis Infective Endocarditis Infective endocarditis is infection of the endocardium, usually with bacteria (commonly, streptococci or staphylococci) or fungi. It may cause fever, heart murmurs, petechiae, anemia, embolic... read more , tumors, therapeutic embolization, or chemoembolization), iatrogenic causes (eg, ligation during surgery), vasculitis (via nonthrombotic mechanisms), structural arterial abnormalities (eg, hepatic artery aneurysm Hepatic Artery Aneurysms Aneurysms of the hepatic artery are uncommon. They tend to be saccular and multiple. Causes include infection, arteriosclerosis, trauma, and vasculitis. (See also Overview of Vascular Disorders... read more ), eclampsia Preeclampsia and Eclampsia Preeclampsia is new-onset or worsening of existing hypertension with proteinuria after 20 weeks gestation. Eclampsia is unexplained generalized seizures in patients with preeclampsia. Diagnosis... read more , cocaine use Cocaine Cocaine is a sympathomimetic drug with central nervous system stimulant and euphoriant properties. High doses can cause panic, schizophrenic-like symptoms, seizures, hyperthermia, hypertension... read more , and sickle cell crisis Sickle Cell Disease Sickle cell disease (a hemoglobinopathy) causes a chronic hemolytic anemia occurring almost exclusively in blacks. It is caused by homozygous inheritance of genes for hemoglobin (Hb) S. Sickle-shaped... read more . (See also Overview of Vascular Disorders of the Liver Overview of Vascular Disorders of the Liver The liver has a dual blood supply. The portal vein (which is rich in nutrients and relatively high in oxygen) provides two thirds of blood flow to the liver. The hepatic artery (which is oxygen-rich)... read more .)
Usually, the result is hepatic infarction. In patients with a liver transplant Liver Transplantation Liver transplantation is the 2nd most common type of solid organ transplantation. (See also Overview of Transplantation.) Indications for liver transplantation include Cirrhosis (70% of transplantations... read more or preexisting portal vein thrombosis Portal Vein Thrombosis Portal vein thrombosis causes portal hypertension and consequent gastrointestinal bleeding from varices, usually in the lower esophagus or stomach. Diagnosis is based on ultrasonography. Treatment... read more , hepatic artery thrombosis causes ischemic hepatitis Ischemic Hepatitis Ischemic hepatitis is diffuse liver damage due to an inadequate blood or oxygen supply. (See also Overview of Vascular Disorders of the Liver.) Causes are most often systemic: Impaired hepatic... read more . Because of the liver’s dual blood supply, the liver is somewhat resistant to ischemic hepatitis and infarction.
Symptoms and Signs of Hepatic Artery Occlusion
Hepatic artery occlusion does not elicit symptoms unless hepatic infarction, or ischemic hepatitis Ischemic Hepatitis Ischemic hepatitis is diffuse liver damage due to an inadequate blood or oxygen supply. (See also Overview of Vascular Disorders of the Liver.) Causes are most often systemic: Impaired hepatic... read more , is present. Hepatic infarction may be asymptomatic or cause right upper quadrant pain, fever, nausea, vomiting, and jaundice. Leukocytosis and a high aminotransferase level are common.
Diagnosis of Hepatic Artery Occlusion
Diagnosis of hepatic artery occlusion is confirmed by imaging Imaging Tests of the Liver and Gallbladder Imaging is essential for accurately diagnosing biliary tract disorders and is important for detecting focal liver lesions (eg, abscess, tumor). It is limited in detecting and diagnosing diffuse... read more with Doppler ultrasonography, usually followed by angiography. The choice between CT angiography, magnetic resonance angiography, and celiac arteriography largely depends on availability and expertise. CT may detect a wedge-shaped area of low attenuation.
Treatment of Hepatic Artery Occlusion
Directed at the cause
Treatment is directed at the cause.