Case Report
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Feb 14, 2007; 13(6): 970-972
Published online Feb 14, 2007. doi: 10.3748/wjg.v13.i6.970
Stent placement is effective on both postoperative hepatic arterial pseudoaneurysm and subsequent portal vein stricture: A case report
Toshiaki Ichihara, Tsutomu Sato, Hideaki Miyazawa, Satoshi Shibata, Manabu Hashimoto, Koichi Ishiyama, Yuzo Yamamoto
Toshiaki Ichihara, Tsutomu Sato, Hideaki Miyazawa, Satoshi Shibata, Manabu Hashimoto, Koichi Ishiyama, Yuzo Yamamoto, Departments of Gastroenterological Surgery and Radiology, Akita University School of Medicine, Hondo, Akita 010-8543, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Toshiaki Ichihara, Departments of Gastroenterological Surgery, Akita University School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan. ichihara@gipc.akita-u.ac.jp
Telephone: +81-18-8362614 Fax: +81-18-8846126
Received: November 17, 2006
Revised: December 15, 2006
Accepted: January 17, 2007
Published online: February 14, 2007
Abstract

To treat postoperative bleeding after hepato-pancreato-biliary surgery, interventional radiology has become essential. We report a case of coincidental pseudoaneurysm and jejunal varices that were both successfully treated by stent-grafts. After a pancreaticoduodenectomy, the patient developed a pseudoaneurysm in the hepatic artery and a stenosis in its periphery. After establishing hepatic arterial flow by placing stent-grafts over both the pseudoaneurysm and the stenosis, the pseudoaneurysm was embolized with microcoils. Nine months later, the patient developed jejunal varices caused by a severe stricture in the main trunk of the portal vein. Percutaneous transhepatic portography was performed and stent-grafts were placed over the stenotic segment. A venoplasty using stent-grafts normalized the portal blood flow and the jejunal varices vanished. Although stenosis occurred due to scarred tissues from leakage after pancreaticoduodenectomy, stent-grafts were useful for managing jejunal bleeding post-operatively.

Keywords: Extrahepatic portal vein stenosis, Jejunal varices, Interventional radiology, Stent-graft