Skip to main content

Advertisement

SpringerLink
Log in

Hepatic Artery Pseudoaneurysm: A Report of Seven Cases and a Review of the Literature

  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

To analyze seven cases of hepatic artery pseudoaneurysm (HAP) encountered at our hospital and review the relevant literature.

Methods

We searched the computerized medical record database from January 1, 1996, to September 1, 2003, to identify all cases of HAP, which we then reviewed in detail, examining etiology, findings, laboratory data, therapeutic intervention, complications, and outcome. We then compared these findings with those reported in the literature.

Results

There were five cases of HAP among 18 015 trauma and surgical admissions to the University of California Irvine Medical Center, representing an incidence of 0.03%. There were an additional two cases of HAP among 200 orthotopic liver transplants (OLT). The five HAPs not associated with OLT were preceded by blunt abdominal trauma, liver biopsy, pancreatic pseudocyst, and polyarteritis nodosa, in one patient each, and there was no apparent cause in one patient. Two patients were treated by ligation, and the patients with post-OLT HAP underwent resection and replacement with saphenous bypass grafts. Successful embolization was performed in the other three patients.

Conclusion

Hepatic artery pseudoaneurysm is a rare but dangerous complication of both acute surgical and chronic injury to the hepatic artery. However, early diagnosis and intervention can result in an excellent long-term outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. MN Duce S Soyupak M Inal F Bijnokay (2002) ArticleTitleSpontaneous thromsbosis of a post-traumatic hepatic artery pseudoaneurysm with arterio-biliary fistula in a child: helical CT diagnosis Pediatr Radiol 32 95 Occurrence Handle10.1007/s00247-001-0581-7 Occurrence Handle11819072

    Article  PubMed  Google Scholar 

  2. JM Walton RJ Abraham BJ Perey JH MacGregor DR Campbell (1991) ArticleTitleHepatic artery pseudoaneurysms in acute pancreatitis Can J Surg 34 377–80 Occurrence Handle1:STN:280:By6A3s%2FgslE%3D Occurrence Handle1868396

    CAS  PubMed  Google Scholar 

  3. RW Busuttil BJ Brin (1980) ArticleTitleThe diagnosis and management of visceral artery aneurysms Surgery 88 619–24 Occurrence Handle1:STN:280:Bi6D2MnntlY%3D Occurrence Handle7434201

    CAS  PubMed  Google Scholar 

  4. JC Stanley GB Zelenock (1989) Splanchnic artery aneurysms RB Rutherford (Eds) Vascular surgery Saunders Philadelphia 973–5

    Google Scholar 

  5. M Soudack M Epelman D Gaitini (2003) ArticleTitleSpontaneous thrombosis of hepatic posttraumatic pseudoaneurysms: sonographic and computed tomographic features J Ultrasound Med 22 99–103 Occurrence Handle12523615

    PubMed  Google Scholar 

  6. PJ Tobben AB Zajko JH Sumkin A Bowen CR Fuhrman ML Skolnick et al. (1988) ArticleTitlePseudoaneurysms complicating organ transplantation: roles of CT, duplex sonography, and angiography Radiology 169 65–70 Occurrence Handle1:STN:280:BieA3snkslM%3D Occurrence Handle3047790

    CAS  PubMed  Google Scholar 

  7. E Otah BJ Cushin GN Rozenblit R Neff KE Otah AM Cooperman (2002) ArticleTitleVisceral artery pseudoaneuryms following pancreaticoduodenectomy Arch Surg 137 55–9 Occurrence Handle10.1001/archsurg.137.1.55 Occurrence Handle11772216

    Article  PubMed  Google Scholar 

  8. T Nicholson S Travis D Ettles J Dyet P Sedman K Wedgewood et al. (1999) ArticleTitleHepatic artery angiography and embolization for hemobilia following laparoscopic cholecystectomy Cardiovasc Intervent Radiol 22 20–4 Occurrence Handle10.1007/s002709900323 Occurrence Handle1:STN:280:DyaK1M7ivF2ksg%3D%3D Occurrence Handle9929540

    Article  CAS  PubMed  Google Scholar 

  9. RA Schwartz GP Teitelbaum MD Katz MJ Pentecost (1993) ArticleTitleEffectiveness of transcatheter embolization in the control of hepatic vascular injuries J Vasc Intervent Radiol 4 359–65 Occurrence Handle1:STN:280:ByyB1M7lt1U%3D

    CAS  Google Scholar 

  10. F Hidalgo JA Narvaez M Rene J Dominguez C Sancho X Montanya (1995) ArticleTitleTreatment of hemobilia with selective hepatic artery embolization J Vasc Intervent Radiol 6 793–8 Occurrence Handle1:STN:280:BymC383otFM%3D

    CAS  Google Scholar 

  11. JM Little JW Spence (1971) ArticleTitleAneurysm of an anomalous hepatic artery Br J Surg 58 886–8 Occurrence Handle1:STN:280:CS2D2s%2FltVQ%3D Occurrence Handle5130191

    CAS  PubMed  Google Scholar 

  12. K Yamakado A Nakatsuka N Tanaka K Takano K Matsumura K Takeda (2000) ArticleTitleTranscatheter arterial embolization of ruptured pseudoaneurysms with coils and n-butyl cyanoacrylate J Vasc Intervent Radiol 11 66–72 Occurrence Handle1:STN:280:DC%2BD3c7lsFersQ%3D%3D

    CAS  Google Scholar 

  13. M Venturini E Angeli M Salvioni F De Cobelli C Trentin M Carlucci et al. (2002) ArticleTitleHemorrhage from a right hepatic artery pseudoaneurysm: endovascular treatment with a coronary stent-graft J Endovasc Ther 9 221–4 Occurrence Handle10.1583/1545-1550(2002)009<0221:HFARHA>2.0.CO;2 Occurrence Handle12010105

    Article  PubMed  Google Scholar 

  14. MA Mauro P Jaques (1991) ArticleTitleTranscatheter management of pseudo-aneurysms complicating pancreatitis J Vasc Intervent Radiol 2 527–32 Occurrence Handle1:STN:280:By2C1c3kvFI%3D

    CAS  Google Scholar 

  15. J Golzarian N Nicaise J Deviere M Ghysels D Wery L Dussaussois et al. (1997) ArticleTitleTranscatheter embolization of pseudo-aneurysms complicating pancreatitis Cardiovasc Intervent Radiol 20 435–40 Occurrence Handle10.1007/s002709900189 Occurrence Handle1:STN:280:DyaK1c%2Fit1ynuw%3D%3D Occurrence Handle9354712

    Article  CAS  PubMed  Google Scholar 

  16. PU Reber HU Baer AG Patel S Wildi J Triller MW Buchler (1998) ArticleTitleSuperselective microcoil embolization: treatment of choice in high-risk patients with extrahepatic pseudoaneurysm of the hepatic arteries J Am Coll Surg 186 325–30 Occurrence Handle10.1016/S1072-7515(98)00032-5 Occurrence Handle1:STN:280:DyaK1c7mvFSrsQ%3D%3D Occurrence Handle9510264

    Article  CAS  PubMed  Google Scholar 

  17. TA Salam AB Lumsden LG Martin RB Smith (1992) ArticleTitle3rd. Nonoperative management of visceral aneurysms and pseudoaneurysms Am J Surg 164 215–9 Occurrence Handle1:STN:280:ByyD3snitVQ%3D Occurrence Handle1415917

    CAS  PubMed  Google Scholar 

  18. M Okazaki H Ono F Higashihara Y Koganameru T Nozaki T Hoashi et al. (1991) ArticleTitleAngiographic management of massive hemobilia due to iatrogenic trauma Gastrointest Radiol 16 205–11 Occurrence Handle1:STN:280:By6A2cfktlM%3D Occurrence Handle1879634

    CAS  PubMed  Google Scholar 

  19. J Rösch BD Petersen LD Hall K Ivancev (1990) ArticleTitleInterventional treatment of hepatic arterial and venous pathology: a commentary Cardiovasc Intervent Radiol 13 183–8 Occurrence Handle2121346

    PubMed  Google Scholar 

  20. JC Andrews EA Sabater AJ LeRoy LJ Burgart (2001) ArticleTitlePercutaneous transhepatic endoluminal biliary biopsy with use of a 19-gauge gun J Vasc Interv Radiol 12 1437–9 Occurrence Handle1:STN:280:DC%2BD3MjgtFWnug%3D%3D Occurrence Handle11742021

    CAS  PubMed  Google Scholar 

  21. J Hoevels U Nilsson (1980) ArticleTitleIntrahepatic vascular lesions following nonsurgical percutaneous transhepatic bile duct intubation Gastrointest Radiol 5 127–35 Occurrence Handle1:STN:280:Bi%2BB3c3jslI%3D Occurrence Handle7380153

    CAS  PubMed  Google Scholar 

  22. MA Croce TC Fabian JP Spiers KA Kudsk (1994) ArticleTitleTraumatic hepatic artery pseudoaneurysm with hemobilia Am J Surg 168 253–8

    Google Scholar 

  23. P Samek J Bober A Vrzgula P Mach (2001) ArticleTitleTraumatic hemobilia caused by false aneurysm of replaced right hepatic artery: case report and review J Trauma 51 153–8 Occurrence Handle1:STN:280:DC%2BD3MvhvVWnsA%3D%3D Occurrence Handle11468484

    CAS  PubMed  Google Scholar 

  24. MD Kim H Kim SW Kang BG Jeong (2002) ArticleTitleNontraumatic hepatic artery pseudoaneurysm associated with acute leukemia: a possible complication of pyogenic liver abscess Abdom Imaging 27 458–60 Occurrence Handle10.1007/s00261-001-0078-8 Occurrence Handle1:STN:280:DC%2BD38zit1aksg%3D%3D Occurrence Handle12066246

    Article  CAS  PubMed  Google Scholar 

  25. H Sugimoto T Kaneko T Ishiguchi K Takai T Ohta Y Yagi et al. (2001) ArticleTitleDelayed rupture of a pseudoaneurysm following pancreatoduodenectomy: report of a case Surg Today 31 932–5 Occurrence Handle10.1007/s005950170039 Occurrence Handle1:STN:280:DC%2BD38%2FjtFentg%3D%3D Occurrence Handle11759894

    Article  CAS  PubMed  Google Scholar 

  26. N Sato K Yamaguchi S Shimizu T Morisaki K Yokohata K Chijiiwa et al. (1998) ArticleTitleCoil embolization of bleeding visceral pseudoaneurysms following pancreatectomy: the importance of early angiography Arch Surg 133 1099–102 Occurrence Handle10.1001/archsurg.133.10.1099 Occurrence Handle1:STN:280:DyaK1M%2FgsVylug%3D%3D Occurrence Handle9790208

    Article  CAS  PubMed  Google Scholar 

  27. H Usal P Sayad N Hayek A Hallak F Huie G Ferzli (1998) ArticleTitleMajor vascular injuries during laparoscopic cholecystectomy. An institutional review of experience with 2 589 procedures and literature review Surg Endosc 12 960–2 Occurrence Handle10.1007/s004649900756 Occurrence Handle1:STN:280:DyaK1c3pvVeiuw%3D%3D Occurrence Handle9632870

    Article  CAS  PubMed  Google Scholar 

  28. DJ Deziel KW Millikan SG Economou A Doolas ST Ko MC Airan (1993) ArticleTitleComplications of laparoscopic cholecystectomy: a national survery of 4 292 hospitals and an analysis of 77 604 cases Am J Surg 165 9–14 Occurrence Handle8418705

    PubMed  Google Scholar 

  29. CH Tsai LR Mo CY Chiou QY Ko HS Hwang MH Hwang et al. (1992) ArticleTitleTherapeutic embolization of post-cholecystectomy hepatic artery aneurysm Hepatogastroenterology 39 158–60 Occurrence Handle1:STN:280:By2A2c%2FgtVQ%3D Occurrence Handle1634183

    CAS  PubMed  Google Scholar 

  30. MC Geokas (1968) ArticleTitleThe role of elastase in acute pancreatitis Arch Pathol 86 127–34 Occurrence Handle1:STN:280:CCeA38%2FgtVI%3D Occurrence Handle5660620

    CAS  PubMed  Google Scholar 

  31. AF White S Baum S Buranasiri (1976) ArticleTitleAneurysms secondary to pancreatitis Am J Roentgenol 127 393–6 Occurrence Handle1:STN:280:CSmB2srltlw%3D Occurrence Handle183522

    CAS  PubMed  Google Scholar 

  32. JT Brodsky AD Turnbull (1991) ArticleTitleArterial hemorrhage after pancreatoduodenectomy. The “sentinel bleed” Arch Surg 126 1037–40 Occurrence Handle1:STN:280:By6A387kslA%3D Occurrence Handle1863209

    CAS  PubMed  Google Scholar 

  33. MM Marshall P Muiesan P Srinivasan PA Kane M Rela ND Heaton et al. (2001) ArticleTitleHepatic artery pseudoaneurysms following liver transplantation: incidence, presenting features and management Clin Radiol 56 579–87 Occurrence Handle10.1053/crad.2001.0650 Occurrence Handle1:STN:280:DC%2BD3Mzpt1Ohsw%3D%3D Occurrence Handle11446757

    Article  CAS  PubMed  Google Scholar 

  34. J Madariaga A Tzakis AB Zajko E Tzoracoleftherakis K Tepetes R Gordon et al. (1992) ArticleTitleHepatic artery pseudoaneurysm ligation after orthotopic liver transplantation — a report of 7 cases Transplantation 54 824–8 Occurrence Handle1:STN:280:ByyD28bkvVI%3D Occurrence Handle1440848

    CAS  PubMed  Google Scholar 

  35. RM Merion GD Burtch JM Ham JG Turcotte DA Campbell (1989) ArticleTitleThe hepatic artery in transplantation Transplantation 48 438–43 Occurrence Handle1:STN:280:BiaA1cbgtVc%3D Occurrence Handle2675403

    CAS  PubMed  Google Scholar 

  36. SM Rudich MM Kinkhabwala DK Imagawa (1998) ArticleTitleSuccessful treatment of mycotic hepatic artery pseudoaneurysms with arterial reconstruction and liposomal amphotericin B Liver Transpl Surg 4 91–3 Occurrence Handle10.1002/lt.500040113 Occurrence Handle1:STN:280:DyaK1c7hslWktQ%3D%3D Occurrence Handle9457973

    Article  CAS  PubMed  Google Scholar 

  37. J Fichelle G Colacchio MD Castaing H Bismuth (1997) ArticleTitleInfected false hepatic artery aneurysm after orthotopic liver transplantation treated by resection and reno-hepatic vein graft Ann Vasc Surg 11 300–3 Occurrence Handle10.1007/s100169900050 Occurrence Handle1:STN:280:ByiB1crjsFY%3D Occurrence Handle9140607

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Division of Hepatobiliary and Pancreas Surgery, University of California, Irvine, Orange, CA, 92868, USA

    David S. Finley, Marcelo W. Hinojosa, Mahbod Paya & David K. Imagawa

Authors
  1. David S. Finley
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marcelo W. Hinojosa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mahbod Paya
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. David K. Imagawa
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Finley, D., Hinojosa, M., Paya, M. et al. Hepatic Artery Pseudoaneurysm: A Report of Seven Cases and a Review of the Literature. Surg Today 35, 543–547 (2005). https://doi.org/10.1007/s00595-005-2987-6

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-005-2987-6

Key words

Search

Navigation