Hepatic artery pseudoaneurysm: report of two cases

• Published in: Cirugia y cirujanos Vol. 82; no. 6; p. 674
• Main Authors: Tun-Abraham, Mauro Enrique, Martínez-Ordaz, José Luis, Romero-Hernández, Teodoro
• Format: Journal Article
• Language: Spanish
• Published: Mexico 01-11-2014
• Subjects: Adult; Aged; Aneurysm, False - diagnosis; Aneurysm, False - etiology; Aneurysm, False - therapy; Embolization, Therapeutic; Hepatic Artery; Humans; Male; pseudoaneurisma hepático; arteria hepática; Hepatic pseudoaneurysm; colecistectomía; postoperative complications; hepatic artery; colecystectomy; complicaciones postoperatorias
• ISSN: 2444-054X

Hepatic pseudoaneurysm is rare and potentially fatal. It occurs as a consequence of injury to the vascular wall, erosion diathermy through clips, biliary leakage and secondary infection. The main symptom is intra-abdominal bleeding.
To communicate the case of two patients with hepatic pseudoaneurysm.
Case 1: We present a 43 year-old male with a history of grade IV liver injury due to blunt abdominal trauma and managed surgically. Case 2: A 67 year-old man with bile duct injury after laparoscopic cholecystectomy. Both patients presented with biliary leakage, abdominal sepsis and late intra-abdominal bleeding. Tomographic studies showed the lesion. Superselective embolization was performed proximal and distal to the lesion with good results. During follow-up, none of them showed signs of recurrent bleeding.
Hepatic artery pseudoaneurysm is rare and usually secondary to bile duct injury associated with vascular injury after cholecystectomy or liver trauma. Arteriography with embolization is the best diagnostic and therapeutic procedure. Surgery is indicated for hemodynamically unstable patients, embolization failure or rebleeding. Early diagnosis reduces morbidity and mortality of this complication.