Diagnosis and treatment of hepatic artery pseudoaneurysm following liver transplantation
10.3760/cma.j.issn.1673-9752.2012.06.014
- VernacularTitle:肝移植术后肝动脉假性动脉瘤的诊断和治疗
- Author:
Zhidong ZHU
;
Guosheng DU
;
Jiyong SONG
;
Dehua ZHENG
;
Hongtao CUI
;
Jian GUAN
;
Bingyi SHI
- Publication Type:Journal Article
- Keywords:
Pseudoaneurysms;
Liver transplantation;
Hepatic artery;
Interwentional embolization
- From:
Chinese Journal of Digestive Surgery
2012;(6):546-548
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the diagnosis and treatment of hepatic artery pseudoaneurysm (HAPA) after liver transplantation.Methods The clinical data of 4 patients who had HAPA after liver transplantation at the No.309 Hospital of PLA from April 2002 to April 2010 were retrospectively analyzed.All the 4 patients had abdominal massive hemorrhage,and 2 of them were complicated by bile leakage and bile duct bleeding.Peritoneal effusion was observed in the 4 patients,and 3 of them were complicated by peritoneal infection.All the patients were diagnosed and treated by angiography and exploratory laparotomy.Results The mean time of hemorrhage of ruptured HAPA was 24.6 days (range,14-35 days).One of the patients was diagnosed by exploratory laparotomy,and the other 3 patients were diagnosed by angiography.Hemostasis of HAPA was successed in 1 patient by hepatic artery ligation,2 patients by interventional embolization + endovascular covered coronary stent grafts implantation guided by digital subtraction angiography (DSA),1 patient by interventional embolization.1 patients died of hepatic failure and 1 died of multiple organ disfunction syndrome.Conclusions Early diagnosis of HAPA after liver transplantation is difficult and the mortality is high.Interventional embolization + endovascular covered coronary stent grafts implantation guided by DSA is the first choice for the diagnosis and treatment of HAPA.
