Late hepatic artery pseudoaneurysm: a rare complication after resection of hilar cholangiocarcinoma.
We report an unusual pathological entity of a pseudoaneurysm of the right hepatic artery, which developed two years after the resection of a type II hilar cholangiocarcinoma and secondary to an excessive skeletonization for regional lymphadenectomy and neoadjuvant external-beam radiotherapy. After a sudden and massive hematemesis, a multidetector computed tomographic angiography (MDCTA) showed a hepatic artery pseudoaneurysm. Angiography with embolization of the pseudoaneurysm was attempted using microcoils with adequate patency of the hepatic artery and the occlusion of the pseudoaneurysm. A new episode of hematemesis 3 wk later revealed a partial revascularization of the pseudoaneurysm. A definitive interventional radiological treatment consisting of transarterial embolization (TAE) of the right hepatic artery with stainless steel coils and polyvinyl alcohol particles was effective and well-tolerated with normal liver function tests and without signs of liver infarction.
Briceño
Javier
J
Hepatobiliary Surgery and Liver Transplantation Unit, Department of Surgery, Hospital Reina Sofia, Avenida Menendez Pidal s/n, Cordoba 14004, Spain. javibriceno@hotmail.com.
Naranjo
Alvaro
A
Ciria
Ruben
R
Sánchez-Hidalgo
Juan-Manuel
JM
Zurera
Luis
L
López-Cillero
Pedro
P
D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D001650:Bile Duct Neoplasms / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures / Q000009:adverse effects*; D017024:Chemotherapy, Adjuvant; D018281:Cholangiocarcinoma / Q000601:surgery*; D004621:Embolization, Therapeutic; D006396:Hematemesis / Q000209:etiology; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D020360:Neoadjuvant Therapy; D015641:Radiography, Interventional; D018714:Radiotherapy, Adjuvant; D012008:Recurrence; D016896:Treatment Outcome