Case report of hepatic artery dissection secondary to hepatic artery pseudoaneurysm after living donor liver transplantation.

Lin Ma,Kefei Chen,Yan Luo,Wenwu Ling,Qiang Lu

doi:10.1186/s12876-016-0458-8

Abstract

BackgroundHepatic artery pseudoaneurysm (HAP) and Hepatic artery dissection are rare vascular complications after living donor liver transplantation (LDLT), which may lead to graft loss and death of the recipients. Conventional gray-scale and Doppler ultrasound, as well as contrast-enhanced ultrasound (CEUS), play important roles in identifying vascular complications in the early postoperative period and during follow-up. We report a case of hepatic artery dissection secondary to HAP after LDLT, which was diagnosed and followed for one year by ultrasound. To the best of our knowledge, few studies have reported similar cases after liver transplantation in the English literature.Case presentationA 43-year-old man underwent right-lobe LDLT for treatment of a severe acute hepatitis B infection and was followed up with ultrasound examinations for one year. Conventional gray-scale and Doppler ultrasound combined with contrast-enhanced ultrasound (CEUS) accurately revealed the occurrence of HA dissection secondary to HAP and accompanied by thrombosis and collateral circulation, as well as secondary biliary complications, which provided a prompt diagnosis and guidance for the treatment.ConclusionOur case suggests that ultrasound can help detect hepatic artery pseudoaneurysm and dissection, as well as secondary biliary lesions after LDLT in an accurate and timely manner and provide useful information for the treatment chosen. CEUS shows potential as an important complementary technique to gray-scale and Doppler ultrasound.

Highlights

Hepatic artery pseudoaneurysm (HAP) and Hepatic artery dissection are rare vascular complications after living donor liver transplantation (LDLT), which may lead to graft loss and death of the recipients
Our case suggests that ultrasound can help detect hepatic artery pseudoaneurysm and dissection, as well as secondary biliary lesions after LDLT in an accurate and timely manner and provide useful information for the treatment chosen
We report a case of HA dissection secondary to HAP and accompanied by thrombosis and collateral circulation as well as secondary biliary complications after LDLT, which was diagnosed and followed for one year by ultrasound

Summary

Conclusion

HAP and HA dissection are rare complications of LDLT and can result in severe consequences. The findings from our case suggest that ultrasound can help detect hepatic artery pseudoaneurysm and dissection, as well as secondary biliary lesions after LDLT in an accurate and timely manner and provide useful information for the treatment chosen. Consent Written informed consent was obtained from the patient’s family for publication of this Case Report and any accompanying images. Authors’ contributions LM collected the data, drafted and revised the manuscript; KFC revised important surgical content of this manuscript; and QL did the ultrasound examination and revised important ultrasonographic content of this manuscript. WWL did the ultrasound examination and collected the data. YL did the ultrasound examination and revised important intellectual content of this manuscript. All authors read and approved the final manuscript

Background

Findings

Discussion