Vascular coil erosion into hepaticojejunostomy following hepatic arterial embolisation

BMC Surgery
Soondoos RaashedNeil D Merrett

Abstract

Right hepatic arterial injury (RHAI) is the most common vascular injury sustained during laparoscopic cholecystectomy, occurring in up to 7% of cholecystectomies. RHAI is also the most common vascular injury associated with a bile duct injury (BDI) and is reported to occur in up to 41 - 61% of cases when routine angiography is employed following a BDI. We present an unusual case of erosion of vascular coils from a previously embolised right hepatic artery into bilio-enteric anastomoses causing biliary obstruction. This is on a background of biliary reconstruction following a major BDI. A 37-year old man underwent a bile duct reconstruction following a major BDI (Strasberg-Bismuth E4 injury) sustained at laparoscopic cholecystectomy. He had two separate bilio-enteric anastomoses of the right and left hepatic ducts and had a modified Terblanche Roux-en-Y access limb formed. Approximately three weeks later he was admitted for significant gastrointestinal bleeding and was hypotensive and anaemic. Selective computed tomography angiography revealed a 2 x 2 centimetre right hepatic artery pseudoaneurysm, which was urgently embolised with radiological coils. Two months later he developed intermittent fevers, rigors, jaundice, and right...Continue Reading

References

Feb 1, 1991·Archives of Surgery·N A Halasz
Jul 1, 1987·The British Journal of Surgery·J E KrigeJ Terblanche
Jan 1, 1996·Cardiovascular and Interventional Radiology·S M RivitzP B Kelsey
Feb 4, 1999·Cardiovascular and Interventional Radiology·T NicholsonC Royston
Oct 2, 2002·Journal of Vascular and Interventional Radiology : JVIR·Orhan S OzkanBrian Goodacre
Jul 9, 2004·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Lygia StewartLawrence W Way
Mar 23, 2006·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Kiran K TuragaRobert J Fitzgibbons
Feb 1, 2007·Journal of Vascular Surgery·Nirman TulsyanKenneth Ouriel
Apr 28, 2007·Vascular and Endovascular Surgery·Dorian deFreitasFrank Parker
Dec 17, 2010·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Steven M Strasberg, W Scott Helton
Apr 13, 2012·Journal of the American College of Surgeons·Leigh Anne DagefordeDerek E Moore
Jan 1, 2011·Case Reports in Gastrointestinal Medicine·Fabio SansonnaRaffaele Pugliese
Oct 20, 2012·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Hamdan S AlGhamdiIbrahim H Altraif
Dec 19, 2013·Case Reports in Gastroenterology·Bezawit D TekolaBrian W Behm
Apr 1, 2014·The Surgical Clinics of North America·Lygia Stewart

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Citations

Apr 22, 2017·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Juan E CorralFrank J Lukens
Oct 17, 2019·ACG Case Reports Journal·Jasna I BeardGeorge Philips
May 29, 2021·Journal of Minimal Access Surgery·Charalampos LampropoulosIoannis Kehagias

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