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Case Reports
. 2014 Jun;14(6):1461-3.
doi: 10.1111/ajt.12551.

Hemorrhagic shock one month following uncomplicated liver transplantation

Z Ren  1 , S Litovsky, D E Eckhoff, D A DuBay
Affiliations
Case Reports

Hemorrhagic shock one month following uncomplicated liver transplantation

Z Ren et al. Am J Transplant. 2014 Jun.
No abstract available

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Figures

Figure 1
Figure 1. CT of the abdomen shows a collection in the porta hepatis/gallbladder fossa that represents a hematoma (labeled H)
The reconstructed hepatic artery is redundant. The arrow represents an abnormality adjacent to the hepatic artery and the duodenum (labeled D).
Figure 2
Figure 2
(A) Gross autopsy photo of the liver and adjacent viscera. The ventral wall of the hepatic artery pseudoaneurysm is ruptured. Arrows point to the recipient hepatic artery. Arrowheads point to the bile duct. The star depicts the ruptured hepatic artery pseudoaneurysm and location of the arterio-biliary fistula. (B) Line art drawing depicting the bile duct, hepatic artery pseudoaneurysm, and arterio-biliary fistula. The insets illustrate the relationship of the hepatic artery pseudoaneurysm and biliary anastomosis before and after rupture.
Figure 3
Figure 3
(A) H&E section of the hepatic artery adjacent to the rupture site shows yeast-like cells and septate hyphae, better seen in (B) (lower power view, GMS stain) and (C) (high power view, GMS stain), classic for Candida species. Aspergillus, in contrast, would typically show hyphae branching at 45 degrees.
See this image and copyright information in PMC

References

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    1. Marshall MM, Muiesan P, Srinivasan P, Kane PA, Rela M, Heaton ND, et al. Hepatic artery pseudoaneurysms following liver transplantation: incidence, presenting features and management. Clinical radiology. 2001 Jul;56(7):579–87. eng. - PubMed
    1. Fistouris J, Herlenius G, Backman L, Olausson M, Rizell M, Mjornstedt L, et al. Pseudoaneurysm of the hepatic artery following liver transplantation. Transplant Proc. 2006 Oct;38(8):2679–82. eng. - PubMed