A Rare Case of Hepatic Artery Vasospasm in a Native Liver

TL;DR

A 40-year-old woman with a native liver experienced a rare case of hepatic artery vasospasm, which was successfully treated with medications typically used for vasospastic angina.

Contribution

This paper reports a rare case of hepatic artery vasospasm occurring in a native liver, offering insights into its management.

Findings

Hepatic artery vasospasm was diagnosed in a patient with a native liver using Doppler ultrasound.

Treatment with a calcium channel blocker and statin led to normalization of liver enzymes.

The case suggests that management strategies for vasospastic angina may be applicable to hepatic artery vasospasm.

Abstract

Hepatic artery vasospasm (HAV) is a relatively uncommon vascular phenomenon that can arise after liver transplants. Its occurrence in a native liver presents an atypical clinical picture. There is a lack of sufficient data on its etiology, incidence, diagnostics and management leaving room for further investigation. This report presents a rare case of HAV in a 40-year-old woman with a native liver. A recent hip fall led to her admission, followed by markedly elevated liver enzymes one week later. Doppler ultrasound (US) revealed patent hepatic vasculature with an elevated resistivity index, which supported our presumed diagnosis. Because of limited data on preventative management for this diagnosis, we used the management of vasospastic angina to start a treatment course, which included a calcium channel blocker and a Statin. Her liver enzymes began to normalize, indicating a favorable response to treatment, ultimately leading to discharge.

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