Infected False Hepatic Artery Aneurysm after Orthotopic Liver Transplantation Treated by Resection and Reno-Hepatic Vein Graft
Autor: | Denis Castaing, Jean-Marc Fichelle, Giovanni Colacchio, Henri Bismuth |
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Rok vydání: | 1997 |
Předmět: |
Adult
Male medicine.medical_specialty Cirrhosis medicine.medical_treatment Hepatic Veins Anastomosis Liver transplantation Hepatic Artery Postoperative Complications Renal Artery Aneurysm Celiac Artery Celiac artery medicine.artery medicine Humans Saphenous Vein Right Renal Artery Renal artery business.industry Anastomosis Surgical General Medicine Staphylococcal Infections medicine.disease Thrombosis Liver Transplantation Radiography Aortic Dissection Surgery Radiology Cardiology and Cardiovascular Medicine business Aneurysm Infected Aneurysm False |
Zdroj: | Annals of Vascular Surgery. 11:300-303 |
ISSN: | 0890-5096 |
DOI: | 10.1007/s100169900050 |
Popis: | Vascular complications after liver transplantation are relatively rare. Thrombosis of the host-transplant arterial anastomosis is the most frequently encountered vascular complication whereas only a few observations of infected anastomotic aneurysms, often leading to death by massive bleeding or loss of the transplant, have been reported. We report herein the case of a patient with an infected false anastomotic aneurysm of the hepatic artery associated with dissection of the celiac artery following orthotopic liver transplantation in a 35-year-old man who had received a liver transplantation for end-stage liver disease secondary to posthepatitis cirrhosis in March 1989. Starting at day 30, he had signs of infection associated with hemocultures positive for Staphylococcus aureus. A subhepatic collection was found on sonography and CT scan and also cultured positive for the same germ. Arteriograms demonstrated a celiac artery dissection associated with a false anastomotic aneurysm of the hepatic artery. Surgical treatment consisted of arterial reconstruction using a saphenous vein graft between the right renal artery and the hepatic artery of the transplant, followed by resection of the hepatic artery aneurysm and the celiac artery. Hepatic ischemia was 12 min. The immediate postoperative course was uneventful and postoperative angiograms showed that the reconstruction was patent at 5 years. |
Databáze: | OpenAIRE |
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