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Surgery Today

, Volume 43, Issue 6, pp 678–681 | Cite as

Intrahepatic artery pseudoaneurysm associated with a metallic biliary stent after living donor liver transplantation: report of a case

  • Noboru HaradaEmail author
  • Ken Shirabe
  • Yuji Soejima
  • Akinobu Taketomi
  • Tomoharu Yoshizumi
  • Katsuhiro Asonuma
  • Yukihiro Inomata
  • Yoshihiko Maehara
Case Report

Abstract

An intrahepatic artery pseudoaneurysm (IHAA) is a very rare but potentially lethal complication occurring after liver transplantation. This report presents a case of an IHAA associated with a metallic biliary stent after liver transplantation. A 40-year-old male underwent living donor liver transplantation (LDLT) using a left lobe graft. The bile duct reconstruction was performed with Roux-en-Y hepaticojejunostomy. He developed obstructive jaundice 5 years after LDLT, and had biliary stricture of the anastomosis area, therefore, the two metallic biliary stents were finally positioned at the stricture of the biliary tract. He suddenly developed hematemesis 8 years after LDLT, and computerized tomography scan showed an IHAA. Although seven interlocking detachable coils were placed at the neck of the aneurysm, hematemesis recurred 3 days after the initial embolization. Therefore, retransplantation was successfully performed 25 days after the embolization of IHAA using a right lobe graft from his son. In conclusion, metal stent insertion can lead to the fatal complication of HAA. The placement of a metallic stent could have been avoided in this case. Percutaneous metallic stent insertion for biliary stenosis after liver transplantation should therefore only be performed in carefully selected patients.

Keywords

Hematemesis Intrahepatic artery aneurysm Coiling 

Abbreviations

HAA

Hepatic artery pseudoaneurysm

IHAA

Intrahepatic artery pseudoaneurysm

LDLT

Living donor liver transplantation

POD

Postoperative day

CT

Computerized tomography

AST

Aspartate aminotransferase

ALT

Alanine aminotransferase

HCV

Hepatitis C virus

IDC

Interlocking detachable coil

PT-INR

Prothrombin time-international normalized ratio

Notes

Conflict of interest

All authors have no conflict of interest to declare.

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Copyright information

© Springer 2012

Authors and Affiliations

  • Noboru Harada
    • 1
    Email author
  • Ken Shirabe
    • 1
  • Yuji Soejima
    • 1
  • Akinobu Taketomi
    • 1
  • Tomoharu Yoshizumi
    • 1
  • Katsuhiro Asonuma
    • 2
  • Yukihiro Inomata
    • 2
  • Yoshihiko Maehara
    • 1
  1. 1.The Department of Surgery and Medical Science, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  2. 2.The Department of Transplant and Pediatric SurgeryKumamoto UniversityKumamotoJapan

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