title: Management of a ruptured pseudoaneurysm of common hepatic artery following pancreaticoduodenectomy.
abstract: Postoperative pseudoaneurysm formation is one of the most feared complications of pancreatic leak following pancreaticoduodenectomy (PD). Surgical repair may be compromised due to a persistent enzymatic insult on the repaired vessel; therefore, preventive measures should be adopted. We report a case of ruptured hepatic artery pseudoaneurysm occurring 12 days following PD in a patient with a postoperative pancreatic fistula. Emergency surgery revealed that the pseudoaneurysm was situated at the point of surgical transfixation of the gastroduodenal artery. The pseudoaneurysm was successfully managed by under-running of the bleeding point combined with the direct application of hemostatic products to the bleeding surface (TachoSil and Tisseel) to act as a barrier from the pancreatic secretions.
authors.affiliation: Hepato Pancreatico Biliary Surgery Unit, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK. Mohammed.AbuHilal@suht.swest.ac.uk
authors.forename: M
authors.initials: M
authors.lastname: Abu Hilal
authors.forename: M J
authors.initials: MJ
authors.lastname: Hallam
authors.forename: B A
authors.initials: BA
authors.lastname: Zeidan
authors.forename: N W
authors.initials: NW
authors.lastname: Pearce
mesh_terms: D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000601:surgery*; D017542:Aneurysm, Ruptured / Q000601:surgery*; D006499:Hepatic Artery / Q000601:surgery*; D006801:Humans; D008297:Male; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*