A Case of Giant Hepatic Pseudoaneurysm Accompanied with Obstructive Jaundice Caused by Infection of Hepatic Artery Catheter system

Hidekazu Yamamoto, Satoshi Nara, Yoshito Tanaka, Kouya Hida, Eiji Yamamoto, Ryuuta Terao, Yasuhiko Konishi and Jun Takeda

Department of Surgery, Osaka Prefectural Saiseikai Izuo Hospital

A 67-year-old man diagnosed with sigmoid colon cancer and liver metastasis had been treated with chemotherapy after sigmoidectomy and two partial hepatectomies via an implanted hepatic artery catheter system connected to a reservoir. As the reservoir was exposed by a subdermally spilled anticancer drug, it was removed although there was no apparent infection. Three monthes later, a giant hepatic pseudoaneurysm occurred, because the remained catether was infected. The splenic artery, functioning as a drainage artery, was obstructed interventionally, but the celiac artery, the aneurysm's main feeding artery, could not be obstructed and it remained patent, resulting in further development of the hepatic pseudoaneurysm, obstructive jaundice, and impending rupture. Surgical ligation of the celiac artery successfully halted blood supply to the aneurysm. Arterial catheter system should be treated carefully to avoid infection, but once infection occurs, adequate treatment should be implemented immediately, because serious complications may occur through the infected system. If pseudoaneurysm is a complication, surgical ligation of the aneurysmal feeding artery is considered an excellent alternative if other intervention fails.

Key words
hepatic artery aneurysm, intrahepatic chemotherapy, infection

Reprint requests
Hidekazu Yamamoto Department of Surgery, Kansai Denryoku Hospital 2-1-7 Fukushima, Fukushima-ku, Osaka, 553-0003 JAPAN

Accepted
February 26, 2003

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