2020 Volume 34 Issue 3 Pages 193-197
A man in his 60s was admitted to our hospital for the treatment for post-operative intrahepatic recurrence of hepatocellular carcinoma with transcatheter arterial chemoembolization (TACE). During hepatic arteriography, angiospasm of the common hepatic artery occurred. We then performed intra-arterial injection of epirubicin-lipiodol suspension via the right inferior phrenic artery as an alternative treatment for TACE. Anorexia appeared at 12 days after the initial an-giography; contrasted-enhanced CT revealed a 17-mm aneurysm in the pancreatic head, a hematoma around the aneurysm, and a passage disorder in the third portion of the duodenum. Emergency superior mesenteric arteriography demonstrated a saccular aneurysm of the anterior inferior pancreatico-duodenal artery near the pancreatic head. Coil embolization was performed for the ruptured aneurysm using the isolation technique. Contrast-enhanced CT after coil embolization proved disappearance of the peripancreatic hematoma, and the passage of the duodenum improved.
In this case, it was considered that retrograde blood flow in the pancreatic arterial arcade increased due to angiospasm of the hepatic artery, and an aneurysm developed in a very short period.
