Objective To investigate the diagnosis and treatment of hepatic artery pseudoaneurysm (HAPA) after liver transplantation. Methods The clinical data of 4 patients who had HAPA after liver transplantation at the No. 309 Hospital of PLA from April 2002 to April 2010 were retrospectively analyzed. All the 4 patients had abdominal massive hemorrhage, and 2 of them were complicated by bile leakage and bile duct bleeding. Peritoneal effusion was observed in the 4 patients, and 3 of them were complicated by peritoneal infection. All the patients were diagnosed and treated by angiography and exploratory laparotomy. Results The mean time of hemorrhage of ruptured HAPA was 24.6 days (range, 14 35 days). One of the patients was diagnosed by exploratory laparotomy, and the other 3 patients were diagnosed by angiography. Hemostasis of HAPA was successed in 1 patient by hepatic artery ligation, 2 patients by interventional embolization+endovascular covered coronary stent grafts implantation guided by digital subtraction angiography (DSA), 1 patient by interventional embolization. 1 patients died of hepatic failure and 1 died of multiple organ disfunction syndrome. Conclusions Early diagnosis of HAPA after liver transplantation is difficult and the mortality is high. Interventional embolization+endovascular covered coronary stent grafts implantation guided by DSA is the first choice for the diagnosis and treatment of HAPA.
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