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Acute bleeding from pseudoaneurysms following liver and pancreatobiliary surgery

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Abstract

Purpose

We report 12 patients with visceral PA following pancreato-biliary and hepatic surgery.

Results

Seven patients (7/11, 63 %) had developed postoperative complications from their original procedure; that information was missing in one patient. Bleeding occurred in eight (three with hemoperitoneum two with haemobilia, and three with GI bleeding through a biliary-enteric anastomosis), three were asymptomatic, and the other one presented with abdominal pain. Eleven patients had an interventional radiology procedure performed (Five underwent angioembolization, a stent was placed in four, and two patients underwent both procedures). Complications related to the procedure developed in 6 (54.5 %) patients, and surgery was required in four of them.

Conclusion

Postoperative pseudoaneurysms (PA) of visceral arteries are rare and usually secondary to vascular injury after pancreato-biliary and liver surgery. They usually present with bleeding and nowadays most are amenable to initial control by interventional radiology.

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References

  1. Tien YW, Wu YM, Liu KL, Ho C, Lee PH. Angiography is indicated for every sentinel bleed after pancreaticoduodenectomy. Ann Surg Oncol. 2008;15:1855–61.

    Article  PubMed  Google Scholar 

  2. Tun-Abraham M, Martinez-Ordaz J, Romero-Hernandez T. Pseudoaneurisma de arteria hepática: reporte de dos casos. Cir Cir [Internet]. 2014;82:674–9. http://www.redalyc.org/articulo.oa?id=66232466011. Accessed 21 Nov 2015.

  3. Finley D, Hinojosa M, Paya M. Hepatic artery pseudoaneurysm: a report of seven cases and a review of the literature. PubMed NCBI [Internet]. 2005;35(7):543–7. http://www.ncbi.nlm.nih.gov/pubmed/15976950. Accessed 1 Dec 2015.

  4. Østerballe L, Helgstrand F, Axelsen T, Hillingsø J, Svendsen L. Hepatic pseudoaneurysm after traumatic liver injury; is CT follow-up warranted? J Trauma Manag Outcomes. 2014;8:18.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Bin Traiki T, Madkhali A, Hassanain M. Hemobilia post laparoscopic cholecystectomy. J Surg Case Rep. 2015;2:159.

    Article  Google Scholar 

  6. Correa-Gallego C, Brennan MF, D´Angelica MI, et al. Contemporary experience with postpancreatectomy hemorrhage: results of 1.122 patients resected between 2006 and 2011. J Am Coll Surg. 2012;215:616–21.

    Article  PubMed  Google Scholar 

  7. García-Marín A, Martín-Gil J, Serralta-de-Colsa D, Pérez-Díaz M, Turégano-Fuentes F. Pseudoaneurisma de la arteria hepática tras colecistectomía. Rev. esp. enferm. dig. [Internet]. 2010;102(1):65–66. http://scielo.isciii.es/scielo.php?pid=S1130-01082010000100017&script=sci_arttext&tlng=es. Accessed 21 Nov 2015.

  8. Milburn J, Hussey J, Bachoo P, Gunn I. Right hepatic artery pseudoaneurysm thirteen months following laparoscopic cholecystectomy. EJVES Extra. 2007;13:1–3.

    Article  Google Scholar 

  9. Madanur MA e. Pseudoaneurysm following laparoscopic cholecystectomy. PubMed NCBI [Internet]. 2007;6(3):294–8. http://www.ncbi.nlm.nih.gov/pubmed/17548254. Accessed 12 Nov 2015.

  10. Yao CA, Arnell TD. Hepatic artery pseudoaneurysm following laparoscopic cholecystectomy. PubMed NCBI [Internet]. 2010;199(1):e10–1. http://www.ncbi.nlm.nih.gov/pubmed/20103061. Accessed 12 Nov 2015.

  11. Christensen T, Matsuoka L, Heestand G, Palmer S, Mateo R, Genyk Y, et al. Iatrogenic pseudoaneurysms of the extrahepatic arterial vasculature: management and outcome. HPB (Oxford). 2006;8:458–64.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Reiter D, Fischman A, Shy B. Hepatic artery pseudoaneurysm rupture: a case report and review of the literature. J Emerg Med. 2013;44(1):100–3.

    Article  PubMed  Google Scholar 

  13. Reber PU e. Life-threatening upper gastrointestinal tract bleeding caused by ruptured extrahepatic pseudoaneurysm after pancreatoduodenectomy. PubMed NCBI [Internet]. 1998;124(1):114–5. http://www.ncbi.nlm.nih.gov/pubmed/9663263. Accessed 5 Dec 2015.

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Authors and Affiliations

  1. Hospital General Universitario Gregorio Marañon, Madrid, Spain

    A. Sanchez Arteaga, M. I. Orue-Echebarria, L. Zarain, A. Lusilla, C. M. Martinez, A. Moreno, M. Cuadrado, C. Rey, M. D. Perez Diaz, M. G. Leyte & F. J. Turégano

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  1. A. Sanchez Arteaga
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  2. M. I. Orue-Echebarria
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  3. L. Zarain
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  4. A. Lusilla
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  5. C. M. Martinez
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  6. A. Moreno
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  7. M. Cuadrado
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  8. C. Rey
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  9. M. D. Perez Diaz
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  10. M. G. Leyte
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  11. F. J. Turégano
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Corresponding author

Correspondence to M. I. Orue-Echebarria.

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Sanchez Arteaga, A., Orue-Echebarria, M.I., Zarain, L. et al. Acute bleeding from pseudoaneurysms following liver and pancreatobiliary surgery. Eur J Trauma Emerg Surg 43, 307–311 (2017). https://doi.org/10.1007/s00068-016-0672-7

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  • DOI: https://doi.org/10.1007/s00068-016-0672-7

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