Abstract
The liver is hard to be generated for infarction, because it receives double blood stream. However, the fatal progress may be traced when the liver infarction occurs extensively. We report a case of hepatic and splenic ischemia after pancreaticoduodenectomy (PD) for pancreatic head cancer with stenosis of celiac trunk. A 75-years-old woman had high amylasemia at the time of periodical blood test. Pancreatic cancer derived from intraductal papillary mucinous neoplasm was diagnosed by imaging. Preoperative angiography revealed stenosis of celiac trunk. We performed sub-stomach preserving PD. The transaminase was severely elevated on post-operative day 2. Abdominal enhanced CT revealed poor contrasted area was extended in the left lobe, caudate lobe of the liver, and the spleen. It indicated that hepatic and splenic ischemia occurred. In addition, poor contrasting area was observed on the mocosa of the left gastric artery domain. We performed an anticoagulant therapy, conservative medical treatment with the prostaglandin. Ischemia was getting improvement. She discharged without any major complication induced by organs infarction.
