A laparotomy 11 hours following the onset of upper abdominal pain in a 39-year-old woman revealed a large hematoma in the right lobe of the liver and a liter of blood in the peritoneal cavity. Specific surgical measures to control the bleeding were not employed. A second episode of hemorrhage occurred 36 hours postoperatively, and thereafter there was no further bleeding. A total of 9 units of blood was used. An arteriogram 12 days later revealed a large defect in the right lobe of the liver consistent with a hematoma. A ruptured and subsequently thrombosed intrahepatic artery aneurysm is believed to be the cause of the bleeding. The intrahepatic defect was also apparent on scan; nine months later it was almost gone. There has been no further trouble during the subsequent two years.
Erskine JM. Ruptured Intrahepatic Aneurysm. Arch Surg. 1973;106(2):219–222. doi:10.1001/archsurg.1973.01350140077022
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