Narumi S, Osorio R W, Freise C E, Stock P G, Roberts J P, Ascher N L
Department of Surgery, University of California, San Francisco, USA.
Clin Transplant. 1998 Dec;12(6):508-10.
A 58-yr-old female with primary biliary cirrhosis underwent an uncomplicated orthotopic liver transplantation. Elevated liver function tests 2 months post-transplantation were evaluated with Doppler ultrasound and a hepatic artery stricture was documented. The hepatic artery stenosis was treated with angioplasty. She developed hemobilia 1 d after the procedure, which was confirmed by angiography. Emergent exploratory laparotomy revealed a pseudoaneurysm at the hepatic artery anastomosis. The pseudoaneurysm was resected and the proper hepatic artery of the graft was anastomosed to the splenic artery of the host using preserved homograft. Her post-operative course was uneventful and liver function tests returned to normal quickly after the surgery. This report will discuss the unusual nature of this complication, and review the problem of hemobilia and pseudoaneurysms in liver transplant recipients.
一名58岁的原发性胆汁性肝硬化女性患者接受了一次无并发症的原位肝移植。移植术后2个月，通过多普勒超声对肝功能检查结果升高的情况进行了评估，结果显示存在肝动脉狭窄。对肝动脉狭窄进行了血管成形术治疗。术后1天，她出现了胆道出血，血管造影证实了这一情况。急诊剖腹探查发现肝动脉吻合处有一个假性动脉瘤。切除假性动脉瘤后，使用保存的同种移植物将移植肝的肝固有动脉与受体的脾动脉进行了吻合。她的术后病程平稳，术后肝功能检查结果很快恢复正常。本报告将讨论这一并发症的特殊性质，并回顾肝移植受者中胆道出血和假性动脉瘤的问题。
