Portal vein pseudoaneurysm secondary to pancreatic lymphoma and biliary stent insertion: a rare cause of haemobilia.

Authors:
Dominic Yu
Dominic Yu
Royal Free Hospital
United Kingdom
Charles Imber
Charles Imber
John Radcliffe Hospital
United Kingdom
George Webster
George Webster
Duke University Medical Center
United States

CVIR Endovasc 2018 28;1(1). Epub 2018 Jun 28.

2University College London Hospital, Euston Road, London, NW1 2BU UK.

Background: Haemobilia, defined as bleeding from the biliary tree, is a rare entity. The most common cause of haemobilia is iatrogenic trauma, which accounts for 70% of cases. Pseudoaneurysms of the portal vein are an extremely rare cause of haemobilia with only four reported cases to date. Conservative treatment, open surgical repair and percutaneous trans hepatic stent-grafting have all been employed in these cases. This displays the lack of consensus regarding the treatment of this condition.We report the first case of a portal vein pseudoaneurysm following endoscopic common bile duct stent placement performed to relieve obstruction of the common bile duct for lymphomatous infiltration of the pancreatic head. The pseudoaneurysm was successfully treated by placement of a percutaneous trans hepatic covered stent-graft.

Case Presentation: A 42-year-old man with a history of lymphomatous infiltration of the pancreatic head and recent endoscopic common bile duct stent placement presented with sudden onset large volume haematemesis. On the portal venous phase of a triple phase CT, this was found to be secondary to a portal vein pseudoaneurysm bulging into the upper portion of the indwelling biliary stent. The pseudoaneurysm was successfully treated by percutaneous trans hepatic placement of a covered vascular stent-graft.

Conclusions: We report a rare case of portal vein pseudo aneurysm successfully treated by percutaneous trans hepatic portal venous covered vascular stent-graft insertion.

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Source
http://dx.doi.org/10.1186/s42155-018-0011-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6319504PMC
June 2018
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References

(Supplied by CrossRef)
Article in Am J Gastroenterol
C Bloechle et al.
Am J Gastroenterol 1994
Article in Radiology
N Fidelman et al.
Radiology 2008
Article in Eur J Vasc Endovasc Surg
GP Fraga et al.
Eur J Vasc Endovasc Surg 2009
Article in Cardiovasc Intervent Radiol
AM Ierardi et al.
Cardiovasc Intervent Radiol 2016

R Javadrasshid et al.
2012
Article in Semin Intervent Radiol
R Navuluri et al.
Semin Intervent Radiol 2016
Article in J Trauma Inj Infect Crit Care
J Pearl et al.
J Trauma Inj Infect Crit Care 2004
Article in Surg Elsevier
P Sandblom et al.
Surg Elsevier 1948
Article in J Radiol Case Rep EduRad
A Wallis et al.
J Radiol Case Rep EduRad 2010
Article in J Trauma Acute Care Surg
DG Weber et al.
J Trauma Acute Care Surg 2016
Article in Curr Surg Reports Springer US
VM Zaydfudim et al.
Curr Surg Reports Springer US 2014

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