scholarly journals Idiopathic Giant Hepatic Artery Pseudoaneurysm

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Ahmed Abdelbaki ◽  
Neeraj Bhatt ◽  
Nishant Gupta ◽  
Shuo Li ◽  
Shady Abdelbaki ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Magnetic Resonance ◽  
Hepatic Artery ◽  
Abdominal Aorta ◽  
Blood Pool ◽  
Magnetic Resonance Angiogram ◽  
Artery Pseudoaneurysm ◽  
Hepatic Artery Pseudoaneurysm ◽  
Life Threatening ◽  
Computed Tomography Angiogram

Hepatic artery pseudoaneurysm (HAP) incidence is rising due to more common use of endoscopic and percutaneous hepatic interventions. HAP is potentially fatal, as it could lead to sudden life-threatening hemorrhage. HAP can be intrahepatic or extrahepatic. On computed tomography angiogram (CTA) and magnetic resonance angiogram (MRA), HAP follows blood pool on multiphasic examination, with brisk arterial enhancement that washes out, similar to the abdominal aorta on later phases. We present a case of idiopathic giant HAP in an 82-year-old male. Currently, angioembolization is replacing surgery as the initial modality of choice for management of this condition.

scholarly journals Hemobilia from a right hepatic artery pseudoaneurysm due to chronic cholecystitis

2019 ◽  
Vol 7 ◽  
pp. 2050313X1987207
Author(s):  
Manjusha Das ◽  
Fritz-Henry Volmar ◽  
Saqib Walayat ◽  
Ryan Nolte
Keyword(s):  
Hepatic Artery ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Chronic Cholecystitis ◽  
Upper Endoscopy ◽  
Acute Blood Loss ◽  
Endoscopic Retrograde ◽  
Artery Pseudoaneurysm ◽  
Right Hepatic Artery ◽  
Hepatic Artery Pseudoaneurysm ◽  
Computed Tomography Angiogram

Splanchnic pseudoaneurysms are rare causes of hemobilia. Specifically, hepatic artery pseudoaneurysms from infectious or inflammatory etiology are even more rare. In this article, we describe our encounter with a 72-year-old female presenting with obstructive jaundice and acute blood loss anemia. Upper endoscopy indicated hemobilia and endoscopic retrograde cholangiopancreatography was completed with stent in place. Post endoscopic retrograde cholangiopancreatography, computed tomography angiogram indicated a right hepatic artery pseudoaneurysm which was the cause of her hemobilia. The patient was ultimately treated with selective coil embolization and interval cholecystectomy.

Rare Case of Hepatic Artery Pseudoaneurysm

2016 ◽  
Vol 88 (3) ◽  
Author(s):  
Przemysław Wyżgowski ◽  
Tomasz Grzela ◽  
Marta Przybył ◽  
Urszula Nowakowska ◽  
Krzysztof Leksowski
Keyword(s):  
Portal Vein ◽  
Hepatic Artery ◽  
Rare Case ◽  
Imaging Diagnostics ◽  
Artery Pseudoaneurysm ◽  
Left Branch ◽  
Hepatic Artery Pseudoaneurysm ◽  
Life Threatening

AbstractHepatic artery aneurysms are rare, but potentially life-threatening vascular pathologies. They are usually discovered incidentally during imaging diagnostics of different pathologies. The study presented a rare case of hepatic artery pseudoaneurym with a fistula to the left branch of the portal vein.

scholarly journals Hepatic Artery Pseudoaneurysm in the Liver Transplant Recipient: A Case Series

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
David P. St. Michel ◽  
Naeem Goussous ◽  
Nathalie L. Orr ◽  
Rolf N. Barth ◽  
Stephen H. Gray ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Hepatic Artery ◽  
Transplant Recipients ◽  
Artery Pseudoaneurysm ◽  
Acute Anemia ◽  
Hepatic Artery Pseudoaneurysm ◽  
Multiple Imaging ◽  
Life Threatening ◽  
Biliary Anastomosis ◽  
Liver Transplant Recipients

Introduction. Hepatic artery pseudoaneurysm is a rare and potentially fatal complication of liver transplantation with a reported incidence of 0.3–2.6% and associated mortality approaching 75%. Clinical presentation typically includes sudden hypotension, gastrointestinal bleed or abnormal liver function tests within two months of transplantation. We report a series of four cases of hepatic artery pseudoaneurysm in adult liver transplant recipients with the goal of identifying factors that may aid in early diagnosis, prior to the development of life threatening complications. Methods. A retrospective chart review at a high volume transplant center revealed 4 cases of hepatic artery pseudoaneurysm among 553 liver transplants (Incidence 0.72%) between March 2013 and March 2017. Results. Two of the four patients died immediately after intervention, one patient survived an additional 151 days prior to death from an unrelated condition and one patient survived at two years follow up. All cases utilized multiple imaging modalities that failed to identify the pseudoaneurysm prior to diagnosis with computed tomography angiography (CTA). Two cases had culture proven preoperative intrabdominal infections, while the remaining two cases manifested a perioperative course highly suspicious for infection (retransplant for hepatic necrosis after hepatic artery thrombosis and infected appearing vessel at reoperation, respectively). Three of the four cases either had a delayed biliary anastomosis or development of a bile leak, leading to contamination of the abdomen with bile. Additionally, three of the four cases demonstrated at least one episode of hypotension with acute anemia at least 5 days prior to diagnosis of the hepatic artery pseudoaneurysm. Conclusions. Recognition of several clinical features may increase the early identification of hepatic artery pseudoaneurysm in liver transplant recipients. These include culture proven intrabdominal infection or high clinical suspicion for infection, complicated surgical course resulting either in delayed performance of biliary anastomosis or a biliary leak, and an episode of hypotension with acute anemia. In combination, the presence of these characteristics can lead the clinician to investigate with appropriate imaging prior to the onset of life threatening complications requiring emergent intervention. This may lead to increased survival in patients with this life threatening complication.

scholarly journals Life-Threatening Rupture of an Idiopathic Left Hepatic Artery Pseudoaneurysm Successfully Treated with Endovascular Coil Embolization

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Jorge E. Sandelis-Pérez ◽  
Andrés Córdova-Toro ◽  
Steven García-Santiago ◽  
Erica G. Otero-Cárdenas ◽  
Pedro Gil de Rubio-Cruz ◽  
...  
Keyword(s):  
Hepatic Artery ◽  
Coil Embolization ◽  
Rare Condition ◽  
Hemodynamic Instability ◽  
Uncontrolled Hypertension ◽  
Left Hepatic Artery ◽  
Artery Pseudoaneurysm ◽  
Hepatic Artery Pseudoaneurysm ◽  
Life Threatening ◽  
Endovascular Coil Embolization

Hepatic artery pseudoaneurysm is a rare condition; they are multifactorial, most of them locating in the extrahepatic vasculature and the mortality associated to its rupture may reach up to 70%. We report a 77 years old female who was admitted due to headache and uncontrolled hypertension and that on her second hospital day developed sudden hemodynamic instability, abdominal pain, fatigue, skin-mucosa pallor, and anemia. Abdominal CT scan with contrast showed a left hepatic artery pseudoaneurysm associated with extensive hemoperitoneum. Patient required emergent hemodynamic stabilization and finally was treated successfully with a superselective endovascular coil embolization. Our patient represents an atypical case of a spontaneous rupture of an idiopathic hepatic artery pseudoaneurysm. Hence, the importance of having a high index of clinical suspicion. Endovascular coil embolization has become the first-line treatment.

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