Acute bleeding from pseudoaneurysms following liver and pancreatobiliary surgery

Eur J Trauma Emerg Surg. 2017 Jun;43(3):307-311. doi: 10.1007/s00068-016-0672-7. Epub 2016 Apr 21.

Abstract

Purpose: We report 12 patients with visceral PA following pancreato-biliary and hepatic surgery.

Results: Seven patients (7/11, 63 %) had developed postoperative complications from their original procedure; that information was missing in one patient. Bleeding occurred in eight (three with hemoperitoneum two with haemobilia, and three with GI bleeding through a biliary-enteric anastomosis), three were asymptomatic, and the other one presented with abdominal pain. Eleven patients had an interventional radiology procedure performed (Five underwent angioembolization, a stent was placed in four, and two patients underwent both procedures). Complications related to the procedure developed in 6 (54.5 %) patients, and surgery was required in four of them.

Conclusion: Postoperative pseudoaneurysms (PA) of visceral arteries are rare and usually secondary to vascular injury after pancreato-biliary and liver surgery. They usually present with bleeding and nowadays most are amenable to initial control by interventional radiology.

Keywords: Angioembolization; Gastrointestinal bleeding; Haemobilia; Hemoperitoneum; Hepatic artery; Pseudoaneurysm.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aneurysm, False / etiology*
  • Embolization, Therapeutic
  • Female
  • Hemorrhage / etiology
  • Hemorrhage / therapy
  • Humans
  • Liver Diseases / surgery*
  • Male
  • Middle Aged
  • Pancreatic Diseases / surgery*
  • Postoperative Complications
  • Vascular System Injuries / complications