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Case Reports
. 2015 Jun 19;4(6):2058460115589338.
doi: 10.1177/2058460115589338. eCollection 2015 Jun.

Stent-graft treatment for extrahepatic portal vein hemorrhage after pancreaticoduodenectomy

Kojiro Suzuki  1 , Tsuyoshi Igami  2 , Tomohiro Komada  1 , Yoshine Mori  1 , Yukihiro Yokoyama  2 , Tomoki Ebata  2 , Shinji Naganawa  1 , Masato Nagino  2
Affiliations
Case Reports

Stent-graft treatment for extrahepatic portal vein hemorrhage after pancreaticoduodenectomy

Kojiro Suzuki et al. Acta Radiol Open. .

Abstract

We report a case of intraperitoneal hemorrhage from the extrahepatic portal vein after pancreaticoduodenectomy for distal bile duct carcinoma. A stent-graft was deployed from the superior mesenteric vein to the main portal vein using a transhepatic approach. After the procedure, the patient remained free of intraperitoneal hemorrhage and was discharged 2 months later.

Keywords: Stent-graft; hemorrhage; pancreaticoduodenectomy; portal vein.

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Figures

Fig. 1.
Fig. 1.
(a) Contrast-enhanced CT 7 days after surgery shows fluid collection (arrowhead) around the pancreatic anastomosis and main portal vein. A drain (arrow) that was placed intraoperatively is seen crossing the main portal vein. (b) Contrast-enhanced study via the drainage tube shows the main portal vein (arrowhead) and peritoneal cavity (arrow). The common hepatic artery had already been embolized with microcoils.
Fig. 2.
Fig. 2.
Portography from the superior mesenteric vein after stent-graft deployment (arrows) shows good portal flow to the liver through the stent-graft. To prevent endoleak, the splenic vein, left gastric vein, and inferior mesenteric vein were embolized with coils and microcoils before stent-graft deployment (arrowheads).
See this image and copyright information in PMC

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