Arantes Rubens Macedo, Pantanali Carlos Andrés Rodriguez, Santos Vinicius Rocha, Carneiro D'Albuquerque Luiz Augusto
Liver and Digestive Organ Transplantation Division, Department of Gastroenterology, Clinicas Hospital, University of São Paulo Medical School, São Paulo, SP, Brazil.
Am J Case Rep. 2017 Feb 24;18:198-202. doi: 10.12659/ajcr.900790.
BACKGROUND Pseudoaneurysm is a rare vascular complication in pancreas transplantation. This complication develops from a disruption of the arterial continuity, usually related to trauma, infection, vasculitis, or complications in vascular procedures. CASE REPORT A 43-year-old man underwent simultaneous pancreas and kidney transplantation for end-stage renal disease. He subsequently developed acute pancreatitis and acute kidney cellular rejection as late complications, thus returning to hemodialysis. A new, uneventful kidney transplantectomy and living donor kidney transplant was performed. One year after the last transplant, the patient presented with moderate abdominal pain, fever, and a pulsatile tumor located in the right iliac fossa. A pseudoaneurysm located in the pancreatic Y graft was observed. The patient was treated using an endovascular and surgical approach. CONCLUSIONS A combined procedure using an endovascular and surgical approach promoted a good vascular control with a lower risk of bleeding in a rare case of pseudoaneurysm in a transplant patient.
假性动脉瘤是胰腺移植中一种罕见的血管并发症。这种并发症源于动脉连续性中断,通常与创伤、感染、血管炎或血管手术并发症有关。病例报告:一名43岁男性因终末期肾病接受了胰腺和肾脏联合移植。他随后出现急性胰腺炎和急性肾细胞排斥反应等晚期并发症,因此又恢复了血液透析。进行了一次新的、顺利的肾移植切除术和活体供肾移植。最后一次移植一年后,患者出现中度腹痛、发热,右髂窝有一个搏动性肿块。观察到胰腺Y形移植物中有一个假性动脉瘤。该患者采用血管内和手术方法进行治疗。结论:在一名移植患者罕见的假性动脉瘤病例中,采用血管内和手术相结合的方法可实现良好的血管控制,且出血风险较低。