title: Sudden death after pancreatic head resection: rupture of hepatic artery caused by clostridial infection.
abstract: BACKGROUND
  Rupture of the hepatic artery caused by clostridial infection has not been reported before.
  
  
  METHODS
  Case report and literature review.
  
  
  RESULTS
  A 75 year-old man was admitted to the hospital for resection of a cystic tumor of the head of the pancreas. A pylorus-preserving radical pancreaticoduodenectomy was performed. On the fifth postoperative day, he developed fever (38.2 degrees C), and computed tomography scanning revealed free air in the subhepatic area near the pancreaticojejunal anastomosis. On the ninth postoperative day, the patient died suddenly. Autopsy revealed a ruptured hepatic artery secondary to clostridial infection.
  
  
  CONCLUSIONS
  Close monitoring and early recourse to invasive diagnostic and therapeutic procedures may be advisable in the presence of suspect findings after pancreatic surgery to prevent this fatal complication.
authors.affiliation: Department of General, Visceral and Transplant Surgery, Tübingen University Hospital, Tübingen, Germany. ikoenigsrainer@web.de
authors.forename: Ingmar
authors.initials: I
authors.lastname: Königsrainer
authors.forename: Ralf
authors.initials: R
authors.lastname: Kurth
authors.forename: Birgit
authors.initials: B
authors.lastname: Haack
authors.forename: Alexander
authors.initials: A
authors.lastname: Braun
authors.forename: Matthias
authors.initials: M
authors.lastname: Marschal
authors.forename: Alexandra
authors.initials: A
authors.lastname: Heininger
authors.forename: Burkhard
authors.initials: B
authors.lastname: Bültmann
authors.forename: Alfred
authors.initials: A
authors.lastname: Königsrainer
mesh_terms: D000368:Aged; D001167:Arteritis / Q000150:complications* / Q000382:microbiology; D003013:Clostridium / Q000145:classification / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000150:complications* / Q000382:microbiology; D017809:Fatal Outcome; D006499:Hepatic Artery / Q000382:microbiology* / Q000473:pathology; D006801:Humans; D008297:Male; D010190:Pancreatic Neoplasms / Q000601:surgery; D011183:Postoperative Complications; D012422:Rupture, Spontaneous