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Published on: April 15, 2021
[Hepatic artery pseudoaneurysm: report of two cases]
Mauro Enrique Tun-Abraham1, José Luis Martínez-Ordaz2, Teodoro Romero-Hernández1
1Servicio de Gastrocirugía, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS, DF, Mexico.
Background:
Hepatic pseudoaneurysm is rare and potentially fatal. It occurs as a consequence of injury to the vascular wall, erosion diathermy through clips, biliary leakage and secondary infection. The main symptom is intra-abdominal bleeding.
Objective:
To communicate the case of two patients with hepatic pseudoaneurysm.
Clinical Cases:
Case 1: We present a 43 year-old male with a history of grade IV liver injury due to blunt abdominal trauma and managed surgically. Case 2: A 67 year-old man with bile duct injury after laparoscopic cholecystectomy. Both patients presented with biliary leakage, abdominal sepsis and late intra-abdominal bleeding. Tomographic studies showed the lesion. Superselective embolization was performed proximal and distal to the lesion with good results. During follow-up, none of them showed signs of recurrent bleeding.
Conclusions:
Hepatic artery pseudoaneurysm is rare and usually secondary to bile duct injury associated with vascular injury after cholecystectomy or liver trauma. Arteriography with embolization is the best diagnostic and therapeutic procedure. Surgery is indicated for hemodynamically unstable patients, embolization failure or rebleeding. Early diagnosis reduces morbidity and mortality of this complication.
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