Management of a ruptured pseudoaneurysm of common hepatic artery following pancreaticoduodenectomy

ScientificWorldJournal. 2007 Oct 12:7:1658-62. doi: 10.1100/tsw.2007.249.

Abstract

Postoperative pseudoaneurysm formation is one of the most feared complications of pancreatic leak following pancreaticoduodenectomy (PD). Surgical repair may be compromised due to a persistent enzymatic insult on the repaired vessel; therefore, preventive measures should be adopted. We report a case of ruptured hepatic artery pseudoaneurysm occurring 12 days following PD in a patient with a postoperative pancreatic fistula. Emergency surgery revealed that the pseudoaneurysm was situated at the point of surgical transfixation of the gastroduodenal artery. The pseudoaneurysm was successfully managed by under-running of the bleeding point combined with the direct application of hemostatic products to the bleeding surface (TachoSil and Tisseel) to act as a barrier from the pancreatic secretions.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Aneurysm, False / surgery*
  • Aneurysm, Ruptured / surgery*
  • Hepatic Artery / surgery*
  • Humans
  • Male
  • Pancreaticoduodenectomy / adverse effects*