Late hepatic artery pseudoaneurysm: a rare complication after resection of hilar cholangiocarcinoma

World J Gastroenterol. 2008 Oct 14;14(38):5920-3. doi: 10.3748/wjg.14.5920.

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.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aneurysm, False / diagnostic imaging
  • Aneurysm, False / etiology*
  • Aneurysm, False / therapy
  • Bile Duct Neoplasms / surgery*
  • Bile Ducts, Intrahepatic / surgery*
  • Biliary Tract Surgical Procedures / adverse effects*
  • Chemotherapy, Adjuvant
  • Cholangiocarcinoma / surgery*
  • Embolization, Therapeutic
  • Hematemesis / etiology
  • Hepatic Artery* / diagnostic imaging
  • Humans
  • Lymph Node Excision
  • Male
  • Neoadjuvant Therapy
  • Radiography, Interventional
  • Radiotherapy, Adjuvant
  • Recurrence
  • Treatment Outcome