Dissecting Pseudoaneurysm of the Proper Hepatic Artery Repaired by Primary Anastomosis: A Case Report

Background. Although rare, visceral artery pseudoaneurysms often present as surgical emergencies with a specific mortality rate as high as 35% related to aneurysmal rupture. Risk factors for the development of iatrogenic pseudoaneurysms include anticoagulation, female gender, obesity, and vessel cal...

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Main Authors: Roshan Razik, Aria Fallah, Charbel Sandroussi, Alice C. Wei, Ian D. McGilvray
Format: Article
Language:English
Published: Hindawi Limited 2012-01-01
Series:Case Reports in Surgery
Online Access:http://dx.doi.org/10.1155/2012/804919
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spelling doaj-a772e1d16b5b44ab85fdad0685216e552020-11-24T23:14:21ZengHindawi LimitedCase Reports in Surgery2090-69002090-69192012-01-01201210.1155/2012/804919804919Dissecting Pseudoaneurysm of the Proper Hepatic Artery Repaired by Primary Anastomosis: A Case ReportRoshan Razik0Aria Fallah1Charbel Sandroussi2Alice C. Wei3Ian D. McGilvray4Department of Medicine, Toronto General Hospital, 200 Elizabeth Street, Eaton Wing 14-217, Toronto, ON, M5G 2C4, CanadaDivision of Neurosurgery, Toronto Western Hospital, 399 Bathurst Street, 4W-436, Toronto, ON, M5T 2S8, CanadaDivision of General Surgery, Toronto General Hospital, 200 Elizabeth Street, Eaton Wing 10-215, Toronto, ON, M5G 2C4, CanadaDivision of General Surgery, Toronto General Hospital, 200 Elizabeth Street, Eaton Wing 10-215, Toronto, ON, M5G 2C4, CanadaDivision of General Surgery, Toronto General Hospital, 200 Elizabeth Street, Eaton Wing 10-215, Toronto, ON, M5G 2C4, CanadaBackground. Although rare, visceral artery pseudoaneurysms often present as surgical emergencies with a specific mortality rate as high as 35% related to aneurysmal rupture. Risk factors for the development of iatrogenic pseudoaneurysms include anticoagulation, female gender, obesity, and vessel calcification. Case Report. We present a case of an elderly female who developed a dissecting pseudoaneurysm of the proper hepatic artery after undergoing routine surgery to resect a large duodenal adenoma. Surgical repair comprised of resection and primary anastomosis was employed resulting in a favourable outcome. Discussion/Conclusion. Surgical management reduces the risk of hepatic ischemia, biliary complications, and abscess formation. Although stenting, coil embolization, and thrombin injection are all plausible options for management, we propose that surgical reconstruction be considered seriously as a treatment for such spontaneous pseudoaneurysms.http://dx.doi.org/10.1155/2012/804919
collection DOAJ
language English
format Article
sources DOAJ
author Roshan Razik
Aria Fallah
Charbel Sandroussi
Alice C. Wei
Ian D. McGilvray
spellingShingle Roshan Razik
Aria Fallah
Charbel Sandroussi
Alice C. Wei
Ian D. McGilvray
Dissecting Pseudoaneurysm of the Proper Hepatic Artery Repaired by Primary Anastomosis: A Case Report
Case Reports in Surgery
author_facet Roshan Razik
Aria Fallah
Charbel Sandroussi
Alice C. Wei
Ian D. McGilvray
author_sort Roshan Razik
title Dissecting Pseudoaneurysm of the Proper Hepatic Artery Repaired by Primary Anastomosis: A Case Report
title_short Dissecting Pseudoaneurysm of the Proper Hepatic Artery Repaired by Primary Anastomosis: A Case Report
title_full Dissecting Pseudoaneurysm of the Proper Hepatic Artery Repaired by Primary Anastomosis: A Case Report
title_fullStr Dissecting Pseudoaneurysm of the Proper Hepatic Artery Repaired by Primary Anastomosis: A Case Report
title_full_unstemmed Dissecting Pseudoaneurysm of the Proper Hepatic Artery Repaired by Primary Anastomosis: A Case Report
title_sort dissecting pseudoaneurysm of the proper hepatic artery repaired by primary anastomosis: a case report
publisher Hindawi Limited
series Case Reports in Surgery
issn 2090-6900
2090-6919
publishDate 2012-01-01
description Background. Although rare, visceral artery pseudoaneurysms often present as surgical emergencies with a specific mortality rate as high as 35% related to aneurysmal rupture. Risk factors for the development of iatrogenic pseudoaneurysms include anticoagulation, female gender, obesity, and vessel calcification. Case Report. We present a case of an elderly female who developed a dissecting pseudoaneurysm of the proper hepatic artery after undergoing routine surgery to resect a large duodenal adenoma. Surgical repair comprised of resection and primary anastomosis was employed resulting in a favourable outcome. Discussion/Conclusion. Surgical management reduces the risk of hepatic ischemia, biliary complications, and abscess formation. Although stenting, coil embolization, and thrombin injection are all plausible options for management, we propose that surgical reconstruction be considered seriously as a treatment for such spontaneous pseudoaneurysms.
url http://dx.doi.org/10.1155/2012/804919
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