title: Hepatic pseudoaneurysm ruptured into the jejunal limb after hepatectomy for the treatment of gall bladder carcinoma.
abstract: A 74-year-old woman with advanced carcinoma of the gall bladder underwent anterior and medial segmentectomies, extrahepatic bile duct resection, lymph node dissection, and hepaticojejunostomy with retrograde transhepatic biliary drainage. On the sixteenth postoperative day, bleeding was noted through the biliary drain, but it stopped spontaneously. Two days later, the biliary drain showed bleeding again. Ultrasonography revealed mild dilatation of the intrahepatic bile duct. Cholangiography via the drain disclosed a defect in the jejunal limb. Emergency angiography revealed an aneurysm, 2 cm in diameter, in the posterior branch of the right hepatic artery. Contrast medium demonstrated extravasation into the jejunal limb. The pseudoaneurysm was embolized with coils. No further hemorrhage was noted, and the patient was discharged 30 days after operation.
authors.affiliation: Surgery for Organ Function and Biological Regulation, Nippon Medical School, Graduate School of Medicine.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kanda
authors.forename: Takashi
authors.initials: T
authors.lastname: Tajiri
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshida
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Mamada
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Taniai
authors.forename: Youichi
authors.initials: Y
authors.lastname: Kawano
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Mizuguchi
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Shimizu
authors.forename: Tsubasa
authors.initials: T
authors.lastname: Takahashi
authors.forename: Shigeki
authors.initials: S
authors.lastname: Yokomuro
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Arima
authors.forename: Koho
authors.initials: K
authors.lastname: Akimaru
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kumazaki
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000175:diagnosis / Q000628:therapy; D017542:Aneurysm, Ruptured / Q000175:diagnosis / Q000628:therapy; D017734:Bile Ducts, Extrahepatic / Q000601:surgery; D004322:Drainage; D004621:Embolization, Therapeutic; D005260:Female; D005706:Gallbladder Neoplasms / Q000601:surgery*; D006498:Hepatectomy; D006499:Hepatic Artery; D006801:Humans; D007582:Jejunostomy; D007583:Jejunum; D008197:Lymph Node Excision; D011183:Postoperative Complications; D016896:Treatment Outcome