Pseudoaneurysma van de arteria hepatica sinistra bij een patiënt met chronische pancreatitis gecompliceerd met obstructieve icterus

Pseudoaneurysm of the left hepatic artery in a patient with chronic pancreatitis complicated with obstructive jaundice. A pseudoaneurysm of the left hepatic artery that causes an obstructive jaundice is a rare entity that has only been described a few times in scientific literature. We describe the case of a patient with a giant pseudoaneurysm (10 cm diameter) caused by chronic pancreatitis, that compresses the choledochus duct. The diagnosis was made by CT scan (computed tomography). The treatment consisted of a ligation of the afferent and efferent artery and evacuation of the aneurysmatic mass. A persisting bile leak was caused by a haemobiliary fistula between the aneurysmatic sac and choledochus duct. Therefore, a hepaticojejunostomy was performed with a delay of 4 weeks. The patient recovered after a few weeks and left the hospital in a good condition.

Reconstruction of Aberrant Left Hepatic Artery in Orthotopic Liver Transplantation – Single Center Experience

One of the most feared complications in liver transplantation is hepatic arterial thrombosis (HAT). The incidence of HAT in liver transplantation varies from 1.2% and 8%. One of the risk factors for this complication is anatomical complexity of hepatic arterial system. The focus of this short communication is to show our approach in dealing with aberrant left hepatic artery in settings of liver transplantation. This is a single center experience. Between January 2016 and June 2019, we procured and transplanted 357 adult liver allografts. Of these, there were 34 (9.5%) livers with aberrant left hepatic artery. All of them have been reconstructed on bench table. There was no incidence of HAT in the entire cohort with ALHA. The one-year graft survival for this patient cohort was 93.1%. Our surgical approach resulted in a low incidence of HAT of 1% with excellent graft survival.

Recurrent hemoperitoneum due to aneurysm of the left hepatic artery. Even "Ockham's razor" can fail

The infection of Klebsiella variicola constituted a high morbility and mortality disease in the most of its guest. It is tended to be associated with a septic shock which required an intensive treatment most of the times. The pathological mechanisms are not well-defined. A correlation has been made between this clinical case and one likely pathogenicity factor, which could explain these rates. We present the case of a male patient who presented to the emergency department with a septic shock. The patient eventually developed an hemoperitoneum by the aneurysm of the left hepatic artery which is very unusual.