[A case of ruptured common hepatic arterial pseudoaneurysm and penetration into duodenum related with hepatic artery infusion chemotherapy].
In a 64-year-old male patient, liver metastasis recurred after surgery for transverse colon cancer. He received 6 courses of continuous intra-arterial infusion therapy with a catheter for hepatic intra-arterial infusion, which was retained by the GDA-coil technique. In April 2005, the patient suddenly developed hematemesis, and he was hospitalized for emergency treatment. Upper gastrointestinal endoscopy on the day after hospitalization revealed no distinct source of bleeding. Since he had massive hematemesis again on hospital day 4, endoscopic examination was repeated, which revealed that the metallic coil for embolization retained in the gastroduodenal artery protruded from the superior wall of the duodenal bulb with bleeding. Emergency angiography revealed that the bleeding arose from rupture of a common hepatic artery aneurysm. Hemostasis was induced by embolization of the region ranging from the right and left hepatic arteries to the entire common hepatic artery aneurysm with the metallic coil. The present case revealed serious complications of the hepatic intra-arterial chemotherapy and intra-arterial retention of the catheter.
Fukazawa
Maki
M
Department of Surgery, Tokai Hachioji University Hospital.
Oida
Yasuhisa
Y
Tajima
Takayuki
T
Mukai
Masaya
M
Shimizu
Kenji
K
Makuuchi
Hiroyasu
H
D017541:Aneurysm, False / Q000473:pathology*; D017542:Aneurysm, Ruptured / Q000473:pathology*; D004386:Duodenum / Q000098:blood supply*; D005773:Gastroscopy; D006499:Hepatic Artery / Q000187:drug effects*; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000098:blood supply* / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed