Intrahepatic artery pseudoaneurysm associated with a metallic biliary stent after living donor liver transplantation: report of a case.
An intrahepatic artery pseudoaneurysm (IHAA) is a very rare but potentially lethal complication occurring after liver transplantation. This report presents a case of an IHAA associated with a metallic biliary stent after liver transplantation. A 40-year-old male underwent living donor liver transplantation (LDLT) using a left lobe graft. The bile duct reconstruction was performed with Roux-en-Y hepaticojejunostomy. He developed obstructive jaundice 5 years after LDLT, and had biliary stricture of the anastomosis area, therefore, the two metallic biliary stents were finally positioned at the stricture of the biliary tract. He suddenly developed hematemesis 8 years after LDLT, and computerized tomography scan showed an IHAA. Although seven interlocking detachable coils were placed at the neck of the aneurysm, hematemesis recurred 3 days after the initial embolization. Therefore, retransplantation was successfully performed 25 days after the embolization of IHAA using a right lobe graft from his son. In conclusion, metal stent insertion can lead to the fatal complication of HAA. The placement of a metallic stent could have been avoided in this case. Percutaneous metallic stent insertion for biliary stenosis after liver transplantation should therefore only be performed in carefully selected patients.
The Department of Surgery and Medical Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. nharada@surg2.med.kyushu-u.ac.jp
Noboru
N
Harada
Ken
K
Shirabe
Yuji
Y
Soejima
Akinobu
A
Taketomi
Tomoharu
T
Yoshizumi
Katsuhiro
K
Asonuma
Yukihiro
Y
Inomata
Yoshihiko
Y
Maehara
D000328:Adult; D017541:Aneurysm, False / Q000209:etiology* / Q000628:therapy; D004621:Embolization, Therapeutic / Q000379:methods; D006499:Hepatic Artery; D019698:Hepatitis C, Chronic / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008670:Metals / Q000009:adverse effects*; D011183:Postoperative Complications / Q000209:etiology*; D015607:Stents / Q000009:adverse effects*
D008670:Metals