english Krvareća hepatično-kutana fistula – retka komplikacija perkutane biopsije jetre

  • Miroslav Mitrović Military Medical Academy, Clinic for General Surgery
  • Milan Jovanović Clinic for General Surgery, Military Medical Academy, Belgrade, Serbia
  • Mihailo Bezmarević Military Medical Academy, Clinic for General Surgery
  • Boško Milev Military Medical Academy, Clinic for General Surgery
  • Darko Mirković Military Medical Academy, Clinic for General Surgery
DOI: https://doi.org/10.2298/VSP211118007M
Ključne reči: biopsija tankom iglom;, dijagnoza;, krvarenje;, jetra;, hirurgija, operativne procedure;, fistula, vaskularna

Sažetak


Uvod. Arteriovenska fistula predstavlja jednu od komplikacija koja se može javiti prilikom perkutane biopsije jetre (PBJ). Hepatična arteriovenska fistula sa hroničnim krvarenjem iz mesta uboda na koži predstavlja izuzetno retku komplikaciju PBJ. Prikaz bolesnika. Prikazujemo 35-godišnju ženu sa sekundarnom anemijom izazvanom hroničnim krvarenjem na mestu granuloma, izazvanog prethodnom biopsijom jetre rađenoj 7 godina ranije. Bolesnica je nekoliko godina ispitivana i lečena zbog anemijskog sindroma. Patološka komunikacija između desne hepatične vene, prednje sekcijske grane vene porte i zadnje arterijske sekcijske grane je detektovana kompjuterizovanom tomografijom, a patološka vaskularizacija u desnom lobusu jetre je dokazana fistulografijom. Zbog neuspele embolizacije, učinjena je laparotomija i nađena je tumorska masa u VI i VII segmentu jetre, koja je komunicirala sa kožom. Tumorska masa je odstranjena atipičnom resekcijom VI i VII segmenta jetre. Zbog akutne hemoragije, posle dva dana učinjena je reeksploracija, kada je nađeno krvarenje sa površine reseciranog parenhima jetre. Bolesnica je otpuštena na kućno lečenje dve nedelje nakon poslednje operacije. Zaključak. Iako je PBJ sigurna procedura, nekada dolazi do komplikacije u vidu krvarenja koje spontano prestaje. Kod prikazane bolesnice je došlo do komplikovane intrahepatične arteriovensko-portne fistule sa formiranjem komunikacije sa mestom uboda na koži. To je prvi opisani slučaj komplikacije te vrste nastale posle PBJ.

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1.      Kose S, Ersan G, Tatar B, Adar P, Sengel BE. Evaluation of percutaneous liver biopsy complica­tions in patients with chronic viral hepatitis. Eurasian J Med 2015; 47(3): 161–4.

2.      Mueller M, Kratzer W, Oeztuerk S, Wilhelm M, Mason RA, Mao R, et al. Percutaneous ultrasonographically guided liver punctures: an analysis of 1961 patients over a period of ten years. BMC Gastroenterol 2012; 12:173.

3.      Midia M, Odedra D, Shuster A, Midia R, Muir J. Predictors of bleeding complications following percutaneous image-guided liver biopsy: a scoping review. Diagn Interv Radiol 2019; 25(1): 71–80.

4.      Okuda K, Musha H, Nakajima Y, Takayasu K, Suzuki Y, Morita M, et al. Frequency of intrahepatic arteriovenous fistula as a sequela to percutaneous needle puncture of the liver. Gastroenterology 1978; 74(6): 1204‒7.

5.      Hellekant C, Olint T. Vascular complications following needle puncture of the liver. An angiographic investigation in the rabbit. Acta Radiol Diagn 1973; 14(5): 577‒82.

6.      Jabbour N, Reyes J, Zajko A, Nour B, Tzakis AG, Starzl TE, et al. Arterioportal fistula following liver biopsy. Three cases occurring in liver transplant recipients. Dig Dis Sci 1995; 40(5): 1041‒4.

7.      Zhang DS, Metwalli Z, Hussain KB. Arterial-Portal Fistula After Percutaneous Liver Biopsy in Hepatic Allograft Causing Hemobilia and Pancreatitis. Clin Gastroenterol Hepatol 2017; 15(1): e3‒e4.

8.      Huang HK, Lin CH, Hsu CC, Yu JC, Liu YC, et al. Hepatocutaneous fistula: a complication after radiofrequency ablation therapy for hepatocellular carcinoma. N Z Med J 2007; 120(1255): U2562.

9.      Fagot H, Guieu M, Zemour J. Intra-hepatic arterio-venous fistula after penetrating liver injury. J Visc Surg 2020; 157(5): 446‒7.

10.   Tanaka H, Iwai A, Sugimoto H, Yoshioka T, Sugimoto T. Intrahepatic arterioportal fistula after blunt hepatic trauma: case reports. J Trauma 1991; 31(1): 143‒6.

11.   Preger L. Hepatic arteriovenous fistula after percutaneous liver biopsy. Am J Roentgenol Radium Ther Nucl Med 1967; 101(3): 619‒20.

12.   Piccinino F, Sagnelli E, Pasquale G, Giusti G. Complications following percutaneous liver biopsy. A multicentre retrospective study on 68,276 biopsies. J Hepatol 1986; 2(2): 165‒73.

13.   Hellekant C. Vascular complications following needle puncture of the liver. Clinical angiography. Acta Radiol Diagn (Stockh) 1976; 17(2): 209‒22.

14.   Wallace S, Medellin H, Nelson RS. Angiographic changes due to needle biopsy of the liver. Radiology 1972; 105(1): 13‒8.

15.   Bloom-Feshbach K, Fischman A, Leong J. A Case of Intrahepatic Arterioportal Fistula After Liver Biopsy. J Clin Gastroenterol 2016; 50(3): 266‒7.

16.   Iwaki T, Miyatani H, Yoshida Y, Matsuura K, Suminaga Y. Gastric variceal bleeding caused by an intrahepatic arterioportal fistula that formed after liver biopsy: a case report and review of the literature. Clin J Gastroenterol 2012; 5(2): 101‒7. 

17.   Kakati BR, Pedersen MR, Chen SY, Hirsch KS, Berggreen PJ, Seetharam AB. Hepatic arterioportal fistula presenting as gastric variceal hemorrhage. J Gastrointestin Liver Dis 2014; 23(2): 211‒4.

18.   Isik FF, Greenfield AJ, Guben J, Birkett D, Menzoian JO. Iatrogenic arterioportal fistulae: diagnosis and management. Ann Vasc Surg 1989; 3(1): 52‒5.

19.   Sniderman KW, Morse SS, Rapoport S, Ross GR. Hemobilia following transhepatic biliary drainage: Occlusion of an hepatoportal fistula by balloon tamponade. Radiology 1985; 154:827.

20.   Bezmarevic M, Engelsman AF, Besselink MG. Laparoscopic segment IVa liver resection: the diamond technique - a video vignette. Colorectal Dis 2019; 21(9): 1099‒1100.

21.   Moris D, Ronnekleiv-Kelly S, Rahnemai-Azar AA, Felekouras E, Dillhoff M, Schmidt C, et al. Parenchymal-Sparing Versus Anatomic Liver Resection for Colorectal Liver Metastases: a Systematic Review. J Gastrointest Surg 2017; 21(6): 1076‒85.

Objavljeno
2023/02/13
Broj časopisa
Vol. 80 Br. 01 (2023): Vojnosanitetski pregled
Rubrika
Prikaz bolesnika