Lower gastrointestinal bleeding due to hepatic artery pseudoaneurysm following laparoscopic cholecystectomy

Mate, Ajay; Surnare, Kailas R; Deolekar, Samir S; Gvalani, Anil Kumar

doi:10.4103/0972-9941.107135

Cited by 8 publications

(12 citation statements)

References 3 publications

(9 reference statements)

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“…Hepatic artery pseudoaneurysm (HAP) is a rare complication of liver injuries following blunt abdominal trauma (1)(2)(3). HAP rupture is the most dangerous and fatal obstacle, which usually presents itself as vague abdominal discomfort, gastrointestinal bleeding, and hemobilia (4)(5)(6). Although radiological intervention may prevent the need of aggressive treatments, mortality rate is still about 20% to 50% (7,8).…”

Section: Introductionmentioning

confidence: 99%

Intrahepatic Artery Pseudoaneurysm as a Delayed Presentation of Blunt Abdominal Trauma

Sanei¹,

Kolahdouzan²,

Jafari³

2017

Arch Trauma Res

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Arterial pseudoaneurysm is an uncommon life-threatening complication in blunt trauma patients. Blunt liver injury may lead to hepatic artery pseudoaneurysm. Radiological intervention is the method of choice in diagnosis and treatment of hepatic artery pseudoaneurysm. However, surgical intervention is advised for unstable patients with large leaking defects. This study reports a case of 53-year-old female who was admitted with vague abdominal pain. She had experienced a blunt abdominal trauma a year ago and had gone under liver packing procedure. The CT-scan results showed hematoma in RUQ region and leaking pseudoaneurysm of right hepatic artery. Hematoma was drained and partial liver resection and hepatic arterioraphy were done through laparotomy.

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Section: Introductionmentioning

confidence: 99%

Intrahepatic Artery Pseudoaneurysm as a Delayed Presentation of Blunt Abdominal Trauma

Sanei¹,

Kolahdouzan²,

Jafari³

2017

Arch Trauma Res

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“…6 Failure may be due to the difficulty in approaching the PSA in the presence of a thrombosed proximal vessel, such as the coeliac or tortuous hepatic arteries. 5,11,24,36,48,55 In patients where cannulation is feasible, embolisation failure could be related to an inability to isolate the bleeding vessel, misidentification of the bleeding vessel or incomplete occlusion despite the disappearance of the sac or feeding vessel on post-embolisation angiography. 6,22 In addition, smaller vessels may feed the PSA and contribute to rebleeding, which may not be easily detected during angiography.…”

Section: 7 D I a G N O S T I C A N D T H E R A P E U T I C I N V E mentioning

confidence: 99%

“…7 Erosion of a PSA into the cystic duct stump or GI tract forming a fistula between the two structures has been previously reported. 5,9,23,24,35,40 This could involve the duodenum, leading to haematemesis, the jejunum, for example in a patient presenting with lower GI bleeding who had previously undergone Roux-en-Y reconstruction following a stomach carcinoma, or hepatic flexure in a patient presenting with hematochezia. 23,24,35,40 In most patients (80%), the PSA usually presents approximately one month following the LC surgery; however, delayed PSA presentation as late as five years after the surgery has been reported.…”

Section: Literature Review M E T H O D Smentioning

confidence: 99%

“…Among the cases which specified the gender or age of the patient, 45.2% were male and the age ranged from 12-81 years with a mean age of 49.8 years. 4,5,[9][10][11][12][13]15,[17][18][19][20][21][24][25][26][27][28][29][30][31][33][34][35][37][38][39][40][41][42][43][46][47][48]51,57,58,60,62 The time of presentation following the LC procedure ranged from six days to five years with a mean of 36 days. [3][4][5][7][8][9][10][11][12][13]15,…”

Section: Literature Review M E T H O D Smentioning

confidence: 99%

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Hepatic or Cystic Artery Pseudoaneurysms Following a Laparoscopic Cholecystectomy: Literature review of aetiopathogenesis, presentation, diagnosis and management

Machado¹,

Alzadjali²,

Kakaria³

et al. 2017

SQUMJ

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Pseudoaneurysms (PSAs) of the hepatic and/or cystic artery are a rare complication following a laparoscopic cholecystectomy (LC). Generally, PSA cases present with haemobilia several weeks following the procedure. Transarterial embolisation (TAE) is considered the optimal management approach. We report a 70-year-old woman who presented to the Sultan Qaboos University Hospital, Muscat, Oman, in 2016 with massive hemoperitoneum two weeks after undergoing a LC procedure in another hospital. She was successfully managed using coil TAE. An extensive literature review revealed 101 cases of hepatic or cystic artery PSAs following a LC procedure. Haemobilia was the main presentation (85.1%) and the mean time of postoperative presentation was 36 days. The hepatic artery was involved in most cases (88.1%), followed by the cystic artery (7.9%) and a combination of both (4.0%). Most cases were managed with TAE (72.3%), with a 94.5% success rate. The overall mortality rate was 2.0%.

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“…Because it brings little damage and interference to internal organs and patients can recover quickly afterwards, LC has become the first operation choice for biliary tract diseases. However, the increased excitement of gastrointestinal sympathetic nerves, inhibited gastrointestinal function, and subsequent decreased gastrointestinal peristalsis and tension led by operation anesthesia, peritoneal stimulation, and traction during operation are possible to cause corresponding complications [4][5][6][7][8] . Therefore, it's of great significance to restore gastrointestinal function in promoting the post-operative recovery.…”

Section: Discussionmentioning

confidence: 99%

Effect of acupoint injection of Neostigmine on gastrointestinal function after cholecystectomy

Qiu

Jiang

2015

J. Acupunct. Tuina. Sci.

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Objective: To observe the effect of acupoint injection with Neostigmine Methylsulfate at Zusanli (ST 36) on gastrointestinal function of patients after laparoscopic cholecystectomy.Methods: Totally 120 patients undergone laparoscopic cholecystectomy were randomized into an acupoint injection group, a muscular injection group, and a blank control group at 1:1:1 by random number table, 40 cases in each group. The blank control group was intervened by conventional post-operation treatment, the acupoint injection group was by acupoint injection with Neostigmine Methylsulfate 2 mL at bilateral Zusanli (ST 36) in addition to the treatment given to the blank control group, and the muscular injection group was by muscular injection with Neostigmine Methylsulfate 2 mL in addition to the treatment given to the blank control group. The two injection groups both received injection twice a day, totally for 3 d at most. The restored time of bowel sounds, initial flatulence time, defecation time and clinical efficacy were observed. Results: After treatment, there were significant differences in comparing the restored time of bowel sounds among the three groups (F＝17.30, P＜0.05), the acupoint injection group and muscular injection group were significantly different from the blank control group (P＜0.05), and there was a significant difference between the acupoint injection group and muscular injection group (P＜0.05); there were significant differences in comparing the initial flatulence time among the three groups (F＝19.12, P＜0.05), and the acupoint injection group was significantly different from the muscular injection group and the blank control group (P＜0.05); there were significant differences in comparing the initial defecation time among the three groups (χ 2 ＝21.23, P＜0.05), while the difference between the acupoint injection group and muscular injection group was statistically insignificant (P＞0.05). The total effective rate was 87.5% in the acupoint injection group, versus 72.5% in the muscular injection group and 60.0% in the blank control group, and there were significant differences among the three groups (P＜0.05). Conclusion: Acupoint injection with Neostigmine Methylsulfate at Zusanli (ST 36) can shorten the restored time of bowel sounds and flatulence time in patients undergone laparoscopic cholecystectomy, and the efficacy is more significant compared to muscular injection with Neostigmine Methylsulfate.

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Lower gastrointestinal bleeding due to hepatic artery pseudoaneurysm following laparoscopic cholecystectomy

Cited by 8 publications

References 3 publications

Intrahepatic Artery Pseudoaneurysm as a Delayed Presentation of Blunt Abdominal Trauma

Intrahepatic Artery Pseudoaneurysm as a Delayed Presentation of Blunt Abdominal Trauma

Hepatic or Cystic Artery Pseudoaneurysms Following a Laparoscopic Cholecystectomy: Literature review of aetiopathogenesis, presentation, diagnosis and management

Effect of acupoint injection of Neostigmine on gastrointestinal function after cholecystectomy

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