Multifactorial aetiology of hepatic infarction

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Abstract
The rarity of hepatic infarction has been explained by the protection from ischaemia provided by the double arterial and portal inflow. Hepatic infarction hence should require the association of multiple factors jeopardizing compensatory mechanisms. We report on a case of hepatic infarction related to combined hepatic arterial and portal venous thrombosis after a blunt abdominal trauma, a previously unreported cause of hepatic infarction. Several causes of vascular impairment were present: shear stress injury due to the trauma, protein C deficiency, type II diabetes and administration of glibenclamide, a splanchnic vasoconstrictor agent. There was repermeation of the portal vein and hepatic artery following anticoagulation therapy. Because hepatic infarction is usually explained by the concurrence of several factors impairing the hepatic blood supply, an extensive search for associated conditions is necessary even when a conspicuous cause is present.