Successful Management of Resuscitative Endovascular Balloon Occlusion of the Aorta for Hemorrhagic Shock Due to Ruptured Hepatocellular Carcinoma

Haruka Okada; Yuji Koike; Shotaro Kishimoto; Kosuke Mori; Shohei Imaki; Ikuo Torii; Hirokazu Komatsu

doi:10.2169/internalmedicine.8133-21

CASE REPORTS

Successful Management of Resuscitative Endovascular Balloon Occlusion of the Aorta for Hemorrhagic Shock Due to Ruptured Hepatocellular Carcinoma

Haruka Okada, Yuji Koike, Shotaro Kishimoto, Kosuke Mori, Shohei Imaki, Ikuo Torii, Hirokazu Komatsu

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Keywords: resuscitative endovascular balloon occlusion of the aorta, hepatocellular carcinoma, transcatheter arterial embolization

JOURNAL OPEN ACCESS

2022 Volume 61 Issue 8 Pages 1157-1162

DOI https://doi.org/10.2169/internalmedicine.8133-21

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Abstract

A 68-year-old man was transferred to our hospital because of sudden right costal pain with unmeasurable hypotension. Ultrasonography revealed possible hemorrhagic shock due to ruptured hepatocellular carcinoma (HCC). As the patient was not hemodynamically stable after primary treatment, resuscitative endovascular balloon occlusion of the aorta (REBOA) was performed, and hemodynamic stability was then achieved. Contrast-enhanced computed tomography confirmed the diagnosis. Transcatheter artery embolization with gelatin sponge particles and coils eliminated the extravasation. The patient was discharged on day 36 post-procedure. Our observations suggest that REBOA may help achieve hemodynamic stability in cases of ruptured HCC.

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