S1672 A Rare Case of Hemobilia From a Large Hepatic Artery Pseudoaneurysm Caused by CT-Guided Liver Biopsy

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.

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Endovascular Repair of Ruptured Hepatic Artery Pseudoaneurysm Secondary to Fibromuscular Dysplasia

Vascular and Endovascular Surgery ◽

10.1177/1538574418794075 ◽

2018 ◽

Vol 53 (1) ◽

pp. 66-70 ◽

Cited By ~ 1

Author(s):

Kara A. Rothenberg ◽

Graeme E. McFarland ◽

Jordan R. Stern

Keyword(s):

Hepatic Artery ◽

Rare Case ◽

Fibromuscular Dysplasia ◽

Case Reports ◽

Care Center ◽

Celiac Trunk ◽

Covered Stent ◽

Common Hepatic Artery ◽

Artery Pseudoaneurysm ◽

Hepatic Artery Pseudoaneurysm

We describe successful endovascular treatment of a patient with fibromuscular dysplasia of the celiac axis leading to development of a common hepatic artery pseudoaneurysm with contained rupture. An 81-year-old woman was transferred to our quaternary care center with concern for a hepatic artery rupture. Further imaging demonstrated a common hepatic artery pseudoaneurysm with surrounding hematoma as well as multifocal areas of narrowing and dilatation in the celiac trunk consistent with fibromuscular dysplasia. A similar pattern was subsequently identified in the bilateral renal and carotid arteries. The patient underwent successful endovascular exclusion of the pseudoaneurysm with a balloon-expandable covered stent and was discharged home without incident. Fibromuscular dysplasia is a nonatherosclerotic arteriopathy that can lead to stenosis, occlusion, dissection, and aneurysm formation. While it primarily affects the carotid and renal arteries, there are rare case reports involving the mesenteric vasculature. Endovascular therapy appears to be a feasible treatment option for the complicated sequelae of this condition in the rare case of mesenteric arterial involvement.

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Patient with Jaundice & Melaena: A rare case report on Haemobilia due to Idiopathic Hepatic artery pseudoaneurysm

Journal of the Postgraduate Institute of Medicine ◽

10.4038/jpgim.8282 ◽

2020 ◽

Vol 7 (2) ◽

pp. 114

Author(s):

Sanchayan Thanancheyan ◽

Ghetheeswaran Srivickneswaran ◽

Ketheeswary Sivasethambaram

Keyword(s):

Case Report ◽

Hepatic Artery ◽

Rare Case ◽

Artery Pseudoaneurysm ◽

Hepatic Artery Pseudoaneurysm ◽

Rare Case Report

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Arterio-biliary fistula caused by a hepatic artery pseudoaneurysm in a recently performed liver transplant: successful resolution and long-term liver implant preservation using a covered coronary stent

CVIR Endovascular ◽

10.1186/s42155-020-00191-6 ◽

2020 ◽

Vol 3 (1) ◽

Author(s):

Alfredo Páez-Carpio ◽

Elena Serrano ◽

Federico Zarco ◽

Constantino Fondevila ◽

Marta Burrel

Keyword(s):

Bile Duct ◽

Liver Transplant ◽

Hepatic Artery ◽

Biliary Fistula ◽

Coronary Stent ◽

Artery Pseudoaneurysm ◽

Hepatic Artery Pseudoaneurysm ◽

Successful Resolution ◽

Standardized Treatment

Abstract Background The formation of a hepatic artery pseudoaneurysm in a liver implant is a rare but potentially fatal complication. Fistulization of such pseudoaneurysms into the bile duct is sporadic. The most common causes of hepatic artery pseudoaneurysm are infection at the anastomosis site, inadequate surgical technique, and an iatrogenic origin due to minimally invasive procedures. Currently, there is no standardized treatment in neither of these complications, with surgery and various endovascular procedures among the alternatives available. None of these therapeutic approaches has demonstrated a significant increase in long-term liver implant preservation. Case presentation A 56-year-old man with a two-month liver transplant presented with massive upper gastrointestinal bleeding and hemobilia shortly after the performance of an endoscopic retrograde cholangiopancreatography due to the presence of a hepatic artery pseudoaneurysm with fistulization into the bile duct. This case report describes the successful treatment of both complications, the hepatic artery pseudoaneurysm and the arterio-biliary fistula, using a covered coronary stent placed in the hepatic artery. A year and a half after treatment, the patient maintains a preserved liver implant and a patent hepatic artery. Conclusions Treatment of a hepatic artery pseudoaneurysm with fistulization into bile duct using a covered coronary stent allowed the correct repair of the defect, adequate hemorrhage control, and long-term liver implant preservation.

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