Hepatic artery pseudoaneurysm after pancreaticoduodenectomy treated with coil embolization in combination with portomesenteric venous stenting
Delayed massive hemorrhage after pancreaticoduodenectomy is known as a fatal complication, frequently caused by gastroduodenal artery stump bleeding or hepatic artery pseudoaneurysm. Transarterial hepatic artery embolization is one of the treatment options in such cases. However, hepatic artery embo...
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doaj-7287facd2c3041d98e975e7461ddd1322020-11-25T03:29:19ZengSociety of Gastrointestinal InterventionInternational Journal of Gastrointestinal Intervention2636-00042020-07-019312112410.18528/ijgii20001610.ijgii200016Hepatic artery pseudoaneurysm after pancreaticoduodenectomy treated with coil embolization in combination with portomesenteric venous stentingSeung Chul Han0Tae Hwan Kim1Hee Chul Yang2Jae Uk Chong3Division of Vascular and Interventional Radiology, Department of Radiology, National Health Insurance Service Ilsan Hospital, Goyang, KoreaDivision of Vascular and Interventional Radiology, Department of Radiology, National Health Insurance Service Ilsan Hospital, Goyang, KoreaDivision of Vascular and Interventional Radiology, Department of Radiology, National Health Insurance Service Ilsan Hospital, Goyang, KoreaDivision of Hepatobiliary and Pancreatic Surgery, Department of General Surgery, National Health Insurance Service Ilsan Hospital, Goyang, KoreaDelayed massive hemorrhage after pancreaticoduodenectomy is known as a fatal complication, frequently caused by gastroduodenal artery stump bleeding or hepatic artery pseudoaneurysm. Transarterial hepatic artery embolization is one of the treatment options in such cases. However, hepatic artery embolization can also result in ischemic complications of the liver, even fatal sometimes. We report a case of a 70-year-old male patient with distal common bile duct cancer who underwent pancreaticoduodenectomy. After three weeks, there was a bloody drain component accompanied with a decreased hemoglobin level. The immediate computed tomography scan and subsequent angiography demonstrated a hepatic artery pseudoaneurysm (1.8 cm in size) with segmental narrowing of the portal vein and superior mesenteric vein. The pseudoaneurysm and common hepatic artery were embolized using microcoils, following percutaneous portomesenteric stenting. There was no such ischemic complication as hepatic infarction after the procedure, and the patient was well tolerable. We suggest that the simultaneous portomesenteric stenting prior to hepatic artery embolization may be helpful to reduce the risk of hepatic infarction/failure in a patient with hepatic artery pseudoaneurysm accompanying portomesenteric vein stenosis after pancreaticoduodenectomy.https://doi.org/10.18528/ijgii200016aneurysm, falseliver failuremesenteric veinpancreaticoduodenectomytherapeutic embolization |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Seung Chul Han Tae Hwan Kim Hee Chul Yang Jae Uk Chong |
spellingShingle |
Seung Chul Han Tae Hwan Kim Hee Chul Yang Jae Uk Chong Hepatic artery pseudoaneurysm after pancreaticoduodenectomy treated with coil embolization in combination with portomesenteric venous stenting International Journal of Gastrointestinal Intervention aneurysm, false liver failure mesenteric vein pancreaticoduodenectomy therapeutic embolization |
author_facet |
Seung Chul Han Tae Hwan Kim Hee Chul Yang Jae Uk Chong |
author_sort |
Seung Chul Han |
title |
Hepatic artery pseudoaneurysm after pancreaticoduodenectomy treated with coil embolization in combination with portomesenteric venous stenting |
title_short |
Hepatic artery pseudoaneurysm after pancreaticoduodenectomy treated with coil embolization in combination with portomesenteric venous stenting |
title_full |
Hepatic artery pseudoaneurysm after pancreaticoduodenectomy treated with coil embolization in combination with portomesenteric venous stenting |
title_fullStr |
Hepatic artery pseudoaneurysm after pancreaticoduodenectomy treated with coil embolization in combination with portomesenteric venous stenting |
title_full_unstemmed |
Hepatic artery pseudoaneurysm after pancreaticoduodenectomy treated with coil embolization in combination with portomesenteric venous stenting |
title_sort |
hepatic artery pseudoaneurysm after pancreaticoduodenectomy treated with coil embolization in combination with portomesenteric venous stenting |
publisher |
Society of Gastrointestinal Intervention |
series |
International Journal of Gastrointestinal Intervention |
issn |
2636-0004 |
publishDate |
2020-07-01 |
description |
Delayed massive hemorrhage after pancreaticoduodenectomy is known as a fatal complication, frequently caused by gastroduodenal artery stump bleeding or hepatic artery pseudoaneurysm. Transarterial hepatic artery embolization is one of the treatment options in such cases. However, hepatic artery embolization can also result in ischemic complications of the liver, even fatal sometimes. We report a case of a 70-year-old male patient with distal common bile duct cancer who underwent pancreaticoduodenectomy. After three weeks, there was a bloody drain component accompanied with a decreased hemoglobin level. The immediate computed tomography scan and subsequent angiography demonstrated a hepatic artery pseudoaneurysm (1.8 cm in size) with segmental narrowing of the portal vein and superior mesenteric vein. The pseudoaneurysm and common hepatic artery were embolized using microcoils, following percutaneous portomesenteric stenting. There was no such ischemic complication as hepatic infarction after the procedure, and the patient was well tolerable. We suggest that the simultaneous portomesenteric stenting prior to hepatic artery embolization may be helpful to reduce the risk of hepatic infarction/failure in a patient with hepatic artery pseudoaneurysm accompanying portomesenteric vein stenosis after pancreaticoduodenectomy. |
topic |
aneurysm, false liver failure mesenteric vein pancreaticoduodenectomy therapeutic embolization |
url |
https://doi.org/10.18528/ijgii200016 |
work_keys_str_mv |
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