Treatment of an Artery Pseudoaneurysm and Portal Vein Thrombosis Using an Interventional Radiological Technique Following a Pancreaticoduodenectomy

Abstract

We report a case of artery pseudoaneurysm and portal vein thrombosis following a pancreaticoduodenectomy (PD) that was treated using an interventional radiological technique. A 67-year-old female underwent a PD for the treatment of pancreatic cancer. A pancreatic fistula was diagnosed on postoperative day (POD) 14, and an intraabdominal hemorrhage occurred on POD 16. An emergency angiography showed a pseudoaneurysm at the gastroduodenal arterial stump. Subsequently, a covered stent was placed to prevent rupture of the artery pseudoaneurysm. Thereafter, intraabdominal hemorrhage via an artery pseudoaneurysm occurred on POD 38, 51, and 75. For these artery pseudoaneurysms, stent placement with coil embolization was repeatedly performed. Furthermore, portal vein thrombosis occurred, and a stent was also placed in the portal vein. Finally, the portal vein stent became occluded, but the hepatic artery flow was maintained. Therefore, liver failure did not occur postoperatively. The patient was discharged on POD 146 without any adverse vascular events.