Abstract
We report a rare case of two communicating pseudoaneurysms of the common hepatic artery 1 month postoperatively following pylorus-preserving pancreaticoduodenectomy due an abscess formation. We describe the superselective transcatheteral embolization technique with deployment of interlocking detachable coils and Histoacryl-Lipiodol in this case and discuss the recent literature. Despite the technical success by achieving hemodynamic stability with initial preservation of liver function, the patient died 23 days postembolization due to multiorgan failure.
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Sato N, Yamaguchi K, Shimizu S, et al. (1998) Coil embolization of bleeding visceral pseudoaneurysms following pancreatectomy: The importance of early angiography. Arch Surg 133(10):1099–1102
Stabile BE, Wilson SE, Debas HT (1983) Reduced mortality from bleeding pseudocysts and pseudoaneurysms caused by pancreatitis. Arch Surg 118(1):45–51
Rumstadt B, Schwab M, Korth P, et al. (1998) Hemorrhage after pancreatoduodenectomy. Ann Surg 227(2):236–241
Choi SH, Moon HJ, Heo JS, et al. (2004) Delayed hemorrhage after pancreaticoduodenectomy. J Am Coll Surg 199(2):186–191
Otah E, Cushin BJ, Rozenblit GN, et al. (2002) Visceral artery pseudoaneurysms following pancreatoduodenectomy. Arch Surg 137(1):55–59
Lerut JP, Gianello PR, Otte JB, et al. (1984) Pancreaticoduodenal resection. Surgical experience and evaluation of risk factors in 103 patients. Ann Surg 199(4):432–437
Thakker RV, Gajjar B, Wilkins RA, et al. (1983) Embolisation of gastroduodenal artery aneurysm caused by chronic pancreatitis. Gut 24(11):1094–1098
Hashimoto N, Haji S, Nomura H, et al. (2004) Arterial hemorrhage by pseudoaneurysms following pancreatoduodenectomy. Hepatogastroenterology 51(60):1847–1848
Brodsky JT, Turnbull AD (1991) Arterial hemorrhage after pancreatoduodenectomy. The ‘sentinel bleed.’ Arch Surg 126(8):1037–1040
Shankar S, Russell RC (1989) Haemorrhage in pancreatic disease. Br J Surg 76(8):863–866
Okuno A, Miyazaki M, Ito H, et al. (2001) Nonsurgical management of ruptured pseudoaneurysm in patients with hepatobiliary pancreatic diseases. Am J Gastroenterol 96(4):1067–1071
Reber PU, Baer HU, Patel AG, et al. (1998) Life-threatening upper gastrointestinal tract bleeding caused by ruptured extrahepatic pseudoaneurysm after pancreatoduodenectomy. Surgery 124(1):114–115
Trede M, Schwall G (1988) The complications of pancreatectomy. Ann Surg 207(1):39–47
Sperti C, Pasquali C, Piccoli A, et al. (1996) Survival after resection for ductal adenocarcinoma of the pancreas. Br J Surg 83(5):625–631
Vujic I (1989) Vascular complications of pancreatitis. Radiol Clin North Am 27(1):81–91
Santoro R, Carlini M, Carboni F, et al. (2003) Delayed massive arterial hemorrhage after pancreaticoduodenectomy for cancer. Management of a life-threatening complication. Hepatogastroenterology 50(54):2199–2204
Vujic I, Andersen BL, Stanley JH, et al. (1984) Pancreatic and peripancreatic vessels: Embolization for control of bleeding in pancreatitis. Radiology 150(1):51–55
de Perrot M, Berney T, Buhler L, et al. (1999) Management of bleeding pseudoaneurysms in patients with pancreatitis. Br J Surg 86(1):29–32
Carr JA, Cho JS, Shepard AD, et al. (2000) Visceral pseudoaneurysms due to pancreatic pseudocysts: Rare but lethal complications of pancreatitis. J Vasc Surg 32(4):722–730
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Radeleff, B., Noeldge, G., Heye, T. et al. Pseudoaneurysms of the Common Hepatic Artery Following Pancreaticoduodenectomy: Successful Emergency Embolization. Cardiovasc Intervent Radiol 30, 129–132 (2007). https://doi.org/10.1007/s00270-005-0372-x
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DOI: https://doi.org/10.1007/s00270-005-0372-x