Intrahepatic Artery Pseudoaneurysm-induced Hemobilia Caused by a Plastic Biliary Stent After ABO-incompatible Living-donor Liver Transplantation: A Case Report

Transplant Proc. 2016 Nov;48(9):3178-3180. doi: 10.1016/j.transproceed.2016.02.069.

Abstract

Bile leakage after duct-to-duct anastomosis in living-donor liver transplantation (LDLT) can mostly be managed by therapeutic endoscopic retrograde cholangiopancreatography. Following this, various complications such as biliary infection, pancreatitis, perforation, and bleeding can occur, and endoscopic sphincterotomy is primarily associated with post- endoscopic retrograde cholangiopancreatography bleeding; other causes have been published in case reports. In the present case, a plastic biliary stent used for treating liver abscesses and leakage at the bile duct anastomosis site after ABO-incompatible LDLT resulted in an intrahepatic artery pseudoaneurysm and hemobilia, which were managed by angiography and coil embolization. Although the complex postoperative course after LDLT can obscure the prompt diagnosis of an intrahepatic artery pseudoaneurysm and hemobilia, biliary stenting should be considered as a possible cause.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Anastomosis, Surgical / adverse effects
  • Anastomotic Leak / etiology
  • Anastomotic Leak / pathology
  • Aneurysm, False / etiology*
  • Aneurysm, False / pathology
  • Bile Ducts / surgery*
  • Biliary Tract Surgical Procedures / adverse effects
  • Blood Group Incompatibility
  • Female
  • Hemobilia / etiology*
  • Hepatic Artery / pathology*
  • Humans
  • Liver Transplantation / adverse effects*
  • Liver Transplantation / instrumentation
  • Liver Transplantation / methods
  • Living Donors
  • Male
  • Middle Aged
  • Plastics
  • Risk Factors
  • Stents / adverse effects*
  • Treatment Outcome

Substances

  • Plastics