Diagnostic characteristics and literature review of hepatic artery pseudoaneurysm after liver transplantation
Wu Lilan1, Tang Min2
1Department of Radiology，the Xiamen Branch of Zhongshan Hospital Affiliated to Fudan University, Xiamen 361015, China； 2Department of Radiology， the Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032, China
Abstract：ObjectiveTo investigate the clinical diagnostic features of hepatic artery pseudoaneurysm (HAP) rupture with biliary tract hemorrhage after liver transplantation. MethodsA case of HAP rupture with biliary tract hemorrhage who repeatedly underwent endoscopic retrograde biliary drainage (ERBD) due to biliary anastomotic stenosis after liver transplantation, admitted to Department of Liver Surgery of Zhongshan Hospital Affiliated to Fudan University was analyzed retrospectively， and the relevant literatures were reviewed. ResultsThe patient was admitted for “fever with jaundice for more than one month” on July 6, 2017 after liver transplantation 4 years ago, and repeatedly underwent ERBD surgeries. The patient underwent percuteneous transhepatic cholangio drainage (PTCD) and the right hepatic artery imaging was found. Hepatic angiography confirmed the pseudoaneurysm was located in the right hepatic artery and it ruptured to the biliary tract. After embolization of HAP and PTCD, the symptoms of fever and jaundice were significantly improved. ConclusionAfter liver transplantation, patients with iatrogenic invasive treatment history and unexplained recurrent fever with persistent jaundice should be regularly followed up with computer tomography angiography (CTA) to exclude the possibility of hemobilia due to HAP rupture.
