A Case of Stent Placement for Hemorrhage Caused by Pseudoaneurysm after Pancreatoduodenectomy

Takahisa Ikeda, Akihiko Tsuchida, Keiichiro Inoue, Yoshihiro Yasuda, Ryuji Nakamura, Takashi Ozawa, Akihiro Mimuro, Tatsuya Aoki and Yasuhisa Koyanagi

Department of Surgery, Tokyo Medical University

A 67-year-old man was treated for a diagnosis of intraductal papillary mucinous tumor of the pancreatic head by pylorus preserving pancreatoduodenectomy. The common hepatic artery was injured during surgery and was reconstructed. There was no pancreatic leakage after the operation, permanent lavage was used to treat infection around the drainage tube for pancreatogastrostomy. On the 30^th post operation day, blood appeared in the drainage tube for the pancreatogastrostomy, but the bleeding soon stopped. Two days later, blood was again noted in the drainage fluid, the blood was 1,200 ml. Computed tomography with contrast medium was performed, and a pseudoaneurysm 12 mm in diameter was found proximal to the anastomosis of the common hepatic artery. Angiography was performed immediately, and bleeding from the pseudoaneurysm in common hepatic artery was suspected. The bluding was stopped in transcatheter placement of a stent (5× 30 mm Easy Wall Stent: Boston Scientific, USA) in the common hepatic artery. CT one year later showed patency of the common and proper hepatic arteries.

Key words
intravascular stent, pseudoaneurysm pancreatoduodenectomy

Reprint requests
Takahisa Ikeda Department of Surgery, Tokyo Medical University
6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023 JAPAN

Accepted
September 22, 2004

To read the PDF file you will need Abobe Reader installed on your computer.