Celiacobihepatic venous bypass for liver revascularization in a patient with intrahepatic contained rupture of a common hepatic artery aneurysm Albert.

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Presentation transcript:

Celiacobihepatic venous bypass for liver revascularization in a patient with intrahepatic contained rupture of a common hepatic artery aneurysm Albert Busch, MD, Joachim Reibetanz, MD, Sven Flemming, MD, Ulrich Steger, MD, Richard Kellersmann, MD Journal of Vascular Surgery Volume 60, Issue 1, Pages 230-232 (July 2014) DOI: 10.1016/j.jvs.2013.06.063 Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 1 A, An overview abdominal computed tomography scan and (B) an enlarged image show a 7-cm common hepatic artery aneurysm (HAA; 1). Also shown is a contained rupture into the right liver hilum (2), with a maximum size of 8.7 cm, widely compressing the gallbladder (3) and the bile duct, with consecutive intrahepatic cholestasis (4). The splenic artery appears slightly enlarged, with widespread calcifications, but it has no aneurysm (5). C, Transfemoral angiography of the superior mesenteric artery shows arterial blood supply to both hepatic arteries (arrow) via inferior pancreaticoduodenal collaterals embracing the pseudoaneurysm (*). D, Selective hepatic artery angiography demonstrates the well-perfused common HAA with persistent active bleeding into the ruptured pseudoaneurysm (arrow). No arterial blood flow to the proper hepatic arteries is seen. Journal of Vascular Surgery 2014 60, 230-232DOI: (10.1016/j.jvs.2013.06.063) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 2 A, A computed tomography scan 10 days after the operation shows the well-perfused celiacobihepatic bypass with distal anastomosis to the slightly calcified left and right hepatic arteries (1). Note the slightly enlarged, calcified splenic artery (2), whereas the renal arteries appear normally shaped (3). B, Magnetic resonance angiography at the 12-month follow-up shows a well-consolidated hepatic bypass, without any signs of aneurysm formation. Biliary outflow also presented as normal in magnetic resonance cholangiopancreatography (picture not shown). Journal of Vascular Surgery 2014 60, 230-232DOI: (10.1016/j.jvs.2013.06.063) Copyright © 2014 Society for Vascular Surgery Terms and Conditions