Life-Threatening Ruptured Hepatic Artery Pseudoaneurysm Post-Liver Transplant: A Case Report

Abstract

IntroductionHepatic artery pseudoaneurysm after liver transplantation is a rare condition, which can lead to spontaneous bleeding depending on its extent and location. Treatment involves endovascular and surgical approaches, and in cases of graft failure, liver retransplantation. Case ReportA 42-year-old female underwent deceased donor liver transplantation due to cryptogenic cirrhosis and schistosomiasis with an uneventful postoperative course. However, 18 days after the operation, she presented to the emergency department with abdominal pain, hypotension, and lipothymia. Computed tomography scan revealed a hepatic artery anastomotic pseudoaneurysm, and, due to hemodynamic instability, emergency laparotomy was indicated. During operation, the pseudoaneurysm was found to be ruptured and the recipient hepatic artery was ligated due to life-threatening bleeding. She later developed ischemic cholangiopathy and biliary complications, eventually undergoing retransplantation seven months after the emergency operation. The patient remains well 11 months after the retransplantation. ConclusionWe report a rare case of life-threatening rupture of hepatic artery anastomotic pseudoaneurysm, which required emergency ligation of the recipient hepatic artery and subsequent liver retransplantation due to biliary complications.