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Coil embolization of ruptured intrahepatic pseudoaneurysm through percutaneous transhepatic biliary drainage

  • An, Jee Young (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Lee, Jae Sin (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Kim, Dong Ryul (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Jang, Jae Young (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Jung, Hwa Young (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Park, Jong Ho (Department of Internal Medicine, Changwon Fatima Hospital) ;
  • Jin, Sue Sin (Department of Internal Medicine, Changwon Fatima Hospital)
  • Received : 2017.08.17
  • Accepted : 2017.10.19
  • Published : 2018.06.30

Abstract

A 75-year-old man with chronic cholangitis and a common bile duct stone that was not previously identified was admitted for right upper quadrant pain. Acute cholecystitis with cholangitis was suspected on abdominal computed tomography (CT); therefore, endoscopic retrograde cholangiopancreatography with endonasal biliary drainage was performed. On admission day 5, hemobilia with rupture of two intrahepatic artery pseudoaneurysms was observed on follow-up abdominal CT. Coil embolization of the pseudoaneurysms was conducted using percutaneous transhepatic biliary drainage. After several days, intrahepatic artery pseudoaneurysm rupture recurred and coil embolization through a percutaneous transhepatic biliary drainage tract was conducted after failure of embolization via the hepatic artery due to previous coiling. After the second coil embolization, a common bile duct stone was removed, and the patient presented no complications during 4 months of follow-up. We report a case of intrahepatic artery pseudoaneurysm rupture without prior history of intervention involving the hepatobiliary system that was successfully managed using coil embolization through percutaneous transhepatic biliary drainage.

Keywords

References

  1. Nagaraja R, Govindasamy M, Varma V, Yadav A, Mehta N, Kumaran V, et al. Hepatic artery pseudoaneurysms: a singlecenter experience. Ann Vasc Surg 2013;27:743-9. https://doi.org/10.1016/j.avsg.2012.08.018
  2. Willson TD, Korn JM, Blecha MJ, Podbielski FJ, Connolly MM. Spontaneous rupture of a saccular intrahepatic artery aneurysm. Vasc Endovascular Surg 2012;46:679-81. https://doi.org/10.1177/1538574412456439
  3. Baggio E, Migliara B, Lipari G, Landoni L. Treatment of six hepatic artery aneurysms. Ann Vasc Surg 2004;18:93-9. https://doi.org/10.1007/s10016-003-0042-x
  4. Dolapci M, Ersoz S, Kama NA. Hepatic artery aneurysm. Ann Vasc Surg 2003;17:214-6. https://doi.org/10.1007/s10016-001-0296-0
  5. Yu YH, Sohn JH, Kim TY, Jeong JY, Han DS, Jeon YC, et al. Hepatic artery pseudoaneurysm caused by acute idiopathic pancreatitis. World J Gastroenterol 2012;18:2291-4. https://doi.org/10.3748/wjg.v18.i18.2291
  6. Finley DS, Hinojosa MW, Paya M, Imagawa DK. Hepatic artery pseudoaneurysm: a report of seven cases and a review of the literature. Surg Today 2005;35:543-7. https://doi.org/10.1007/s00595-005-2987-6
  7. Tessier DJ, Fowl RJ, Stone WM, McKusick MA, Abbas MA, Sarr MG, et al. Iatrogenic hepatic artery pseudoaneurysms: an uncommon complication after hepatic, biliary, and pancreatic procedures. Ann Vasc Surg 2003;17:663-9. https://doi.org/10.1007/s10016-003-0075-1
  8. Lumsden AB, Mattar SG, Allen RC, Bacha EA. Hepatic artery aneurysms: the management of 22 patients. J Surg Res 1996;60:345-50. https://doi.org/10.1006/jsre.1996.0055
  9. Abbas MA, Fowl RJ, Stone WM, Panneton JM, Oldenburg WA, Bower TC, et al. Hepatic artery aneurysm: factors that predict complications. J Vasc Surg 2003;38:41-5. https://doi.org/10.1016/S0741-5214(03)00090-9
  10. Cho GH, Lee JJ, Yu SK, Kwon KA, Park DK, Kim YS, et al. A case of non-traumatic hemobilia due to pseudoaneurysm of the hepatic artery. Korean J Gastrointest Endosc 2006;33:173-7. Korean.
  11. Razik R, Fallah A, Sandroussi C, Wei AC, McGilvray ID. Dissecting pseudoaneurysm of the proper hepatic artery repaired by primary anastomosis: a case report. Case Rep Surg 2012;2012:804919.

Cited by

  1. Percutaneous Trans-Hepatic Embolization of an Iatrogenic Extra-Hepatic Pseudoaneurysm of the Right Hepatic Artery in a Patient With Previous Occlusion of the Proper Hepatic Artery: An Endovascular Pro vol.55, pp.8, 2021, https://doi.org/10.1177/15385744211022591