Liver Abscess after Common Hepatic Artery Embolization for Delayed Hemorrhage Following Pancreaticoduodenectomy: Case Report
A 55-year-old man underwent pancreaticoduodenectomy for bile duct carcinoma in March 2009. The patient developed anastomotic leakage and had a short episode of hemorrhage from the drainage tubes with spontaneous disappearance. CT and upper endoscopy did not reveal the source of bleeding. A massive l...
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| Format: | Article |
| Language: | English |
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Wiley
2010-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2010/280430 |
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| author | Yuichi Sanada Hiroki Kondo Satoshi Goshima Masayuki Kanematsu Yoshihiro Tanaka Yasuharu Tokuyama Shinji Osada Kazuhiro Yoshida |
| author_facet | Yuichi Sanada Hiroki Kondo Satoshi Goshima Masayuki Kanematsu Yoshihiro Tanaka Yasuharu Tokuyama Shinji Osada Kazuhiro Yoshida |
| author_sort | Yuichi Sanada |
| collection | DOAJ |
| description | A 55-year-old man underwent pancreaticoduodenectomy for bile duct carcinoma in March 2009. The patient developed anastomotic leakage and had a short episode of hemorrhage from the drainage tubes with spontaneous disappearance. CT and upper endoscopy did not reveal the source of bleeding. A massive life-threatening hemorrhage occurred on the 18th postsurgical day. Emergency angiography showed a 2.7-cm pseudoaneurysm of the gastroduodenal artery stump, and hepatic artery embolization was performed. After embolization, an abscess appeared in segments 2/3 of the liver without involving the right lobe. We treated conservatively by drainage and antibiotics. During the course of therapy after embolization, the patient experienced several episodes of high fever but did not develop hepatic failure. On the 68th day after embolization, the abscess had penetrated to the lesser sac, which was immediately treated by percutaneous drainage. Anastomotic leakage was treated by continuous irrigation from the drain, for which complete resolution was achieved by the 34th day after embolization. The patient was discharged 101 days after embolization. Imaging and the clinical course demonstrate a unique mechanism of abscess formation after embolization. |
| format | Article |
| id | doaj-art-a6b70313a60e49448ddb96bc807f181e |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2010-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-a6b70313a60e49448ddb96bc807f181e2025-02-03T01:00:45ZengWileyCase Reports in Medicine1687-96271687-96352010-01-01201010.1155/2010/280430280430Liver Abscess after Common Hepatic Artery Embolization for Delayed Hemorrhage Following Pancreaticoduodenectomy: Case ReportYuichi Sanada0Hiroki Kondo1Satoshi Goshima2Masayuki Kanematsu3Yoshihiro Tanaka4Yasuharu Tokuyama5Shinji Osada6Kazuhiro Yoshida7Department of Surgical Oncology, Gifu Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, JapanDepartment of Radiology, Gifu Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, JapanDepartment of Radiology, Gifu Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, JapanDepartment of Radiology, Gifu Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, JapanDepartment of Surgical Oncology, Gifu Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, JapanDepartment of Surgical Oncology, Gifu Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, JapanDepartment of Surgical Oncology, Gifu Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, JapanDepartment of Surgical Oncology, Gifu Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, JapanA 55-year-old man underwent pancreaticoduodenectomy for bile duct carcinoma in March 2009. The patient developed anastomotic leakage and had a short episode of hemorrhage from the drainage tubes with spontaneous disappearance. CT and upper endoscopy did not reveal the source of bleeding. A massive life-threatening hemorrhage occurred on the 18th postsurgical day. Emergency angiography showed a 2.7-cm pseudoaneurysm of the gastroduodenal artery stump, and hepatic artery embolization was performed. After embolization, an abscess appeared in segments 2/3 of the liver without involving the right lobe. We treated conservatively by drainage and antibiotics. During the course of therapy after embolization, the patient experienced several episodes of high fever but did not develop hepatic failure. On the 68th day after embolization, the abscess had penetrated to the lesser sac, which was immediately treated by percutaneous drainage. Anastomotic leakage was treated by continuous irrigation from the drain, for which complete resolution was achieved by the 34th day after embolization. The patient was discharged 101 days after embolization. Imaging and the clinical course demonstrate a unique mechanism of abscess formation after embolization.http://dx.doi.org/10.1155/2010/280430 |
| spellingShingle | Yuichi Sanada Hiroki Kondo Satoshi Goshima Masayuki Kanematsu Yoshihiro Tanaka Yasuharu Tokuyama Shinji Osada Kazuhiro Yoshida Liver Abscess after Common Hepatic Artery Embolization for Delayed Hemorrhage Following Pancreaticoduodenectomy: Case Report Case Reports in Medicine |
| title | Liver Abscess after Common Hepatic Artery Embolization for Delayed Hemorrhage Following Pancreaticoduodenectomy: Case Report |
| title_full | Liver Abscess after Common Hepatic Artery Embolization for Delayed Hemorrhage Following Pancreaticoduodenectomy: Case Report |
| title_fullStr | Liver Abscess after Common Hepatic Artery Embolization for Delayed Hemorrhage Following Pancreaticoduodenectomy: Case Report |
| title_full_unstemmed | Liver Abscess after Common Hepatic Artery Embolization for Delayed Hemorrhage Following Pancreaticoduodenectomy: Case Report |
| title_short | Liver Abscess after Common Hepatic Artery Embolization for Delayed Hemorrhage Following Pancreaticoduodenectomy: Case Report |
| title_sort | liver abscess after common hepatic artery embolization for delayed hemorrhage following pancreaticoduodenectomy case report |
| url | http://dx.doi.org/10.1155/2010/280430 |
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