A Case of Stent Placement for Hemorrhage Caused by Pseudoaneurysm after Pancreatoduodenectomy

A 67-year-old man was treated for a diagnosis of intraductal papillary mucinous tumor of the pancreatic head by pylorus preserving pancreatoduodenectomy. The common hepatic artery was injured during surgery and was reconstructed. There was no pancreatic leakage after the operation, permanent lavage was used to treat infection around the drainage tube for pancreatogastrostomy. On the 30th post operation day, blood appeared in the drainage tube for the pancreatogastrostomy, but the bleeding soon stopped. Two days later, blood was again noted in the drainage fluid, the blood was 1, 200ml. Computed tomography with contrast medium was performed, and a pseudoaneurysm 12 mm in diameter was found proximal to the anastomosis of the common hepatic artery. Angiography was performed immediately, and bleeding from the pseudoaneurysm in common hepatic artery was suspected. The bluding was stopped in transcatheter placement of a stent (5×30mm Easy Wall Stent: Boston Scientific, USA) in the common hepatic artery. CT one year later showed patency of the common and proper hepatic arteries.