Briceño J, Naranjo &, Ciria R, Sánchez-Hidalgo JM, Zurera L, López-Cillero P. Late hepatic artery pseudoaneurysm: A rare complication after resection of hilar cholangiocarcinoma. World J Gastroenterol 2008; 14(38): 5920-5923 [PMID: 18855995 DOI: 10.3748/wjg.14.5920]
Corresponding Author of This Article
Dr. Javier Briceño, Hepatobiliary Surgery and Liver Transplantation Unit, Department of Surgery, Hospital Reina Sofía, Avenida Menéndez Pidal s/n, Córdoba 14004, Spain. javibriceno@hotmail.com
Article-Type of This Article
Case Report
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World J Gastroenterol. Oct 14, 2008; 14(38): 5920-5923 Published online Oct 14, 2008. doi: 10.3748/wjg.14.5920
Late hepatic artery pseudoaneurysm: A rare complication after resection of hilar cholangiocarcinoma
Javier Briceño, Álvaro Naranjo, Rubén Ciria, Juan Manuel Sánchez-Hidalgo, Luis Zurera, Pedro López-Cillero
Javier Briceño, Álvaro Naranjo, Rubén Ciria, Juan Manuel Sánchez-Hidalgo, Pedro López-Cillero, Hepatobiliary Surgery and Liver Transplantation Unit, Department of Surgery, Hospital Universitario Reina Sofía, Córdoba 14004, Spain
Luis Zurera, Interventional Radiology Unit, Department of Surgery, Hospital Universitario Reina Sofía, Córdoba 14004, Spain
Author contributions: Briceño J, López-Cillero P and Naranjo A performed surgical procedure; Briceño J and López-Cillero P designed the study; Ciria R and Sánchez-Hidalgo JM prepared the drafts and gave critical revision; Zurera L performed radiological interventions; Briceño J and Ciria R prepared the manuscript.
Supported by Ciberehd (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas); Ciberehed is funded by the Instituto de Salud Carlos III
Correspondence to: Dr. Javier Briceño, Hepatobiliary Surgery and Liver Transplantation Unit, Department of Surgery, Hospital Reina Sofía, Avenida Menéndez Pidal s/n, Córdoba 14004, Spain. javibriceno@hotmail.com
Telephone: +34-957-010132 Fax: +34-957-012876
Received: May 3, 2008 Revised: September 4, 2008 Accepted: September 11, 2008 Published online: October 14, 2008
Abstract
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.
