Hepatic pseudoaneurysm ruptured into the jejunal limb after hepatectomy for the treatment of gall bladder carcinoma.
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.
Kanda
Tomohiro
T
Surgery for Organ Function and Biological Regulation, Nippon Medical School, Graduate School of Medicine.
Tajiri
Takashi
T
Yoshida
Hiroshi
H
Mamada
Yasuhiro
Y
Taniai
Nobuhiko
N
Kawano
Youichi
Y
Mizuguchi
Yoshiaki
Y
Shimizu
Tetsuya
T
Takahashi
Tsubasa
T
Yokomuro
Shigeki
S
Arima
Yasuo
Y
Akimaru
Koho
K
Kumazaki
Tatsuo
T
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