TRUE hepatic infarction in man is extremely rare and difficult to diagnose. Recently I treated a young man who died with this condition. The manifestations of his illness were bizarre, and the clinical entity so poorly recognized that a review of the subject seemed necessary.
The usual explanation for the rarity of hepatic infarction is that the liver has a double blood supply through the hepatic artery and the portal vein.1 However it appears from the pathological studies of Carroll 2 that infarction results solely from hepatic artery occlusion. Experimental ligation of the hepatic artery with a free flow of blood through the portal venous system results in infarction of the liver in the ischemic parts.3 Obstruction of the portal vein alone does not produce infarction of the liver.4
The blood supply of the liver has many collateral pathways so that complete arrest of arterial blood flow