Delayed Hemorrhage of the Hepatic Artery Caused by Biliary Stenting after Concurrent Chemoradiotherapy

Neoadjuvant concurrent chemoradiotherapy has been increasingly used to obtain secondary resectability for locally advanced pancreatic cancers. Although most patients require biliary decompression, only a few studies have investigated the safety of biliary stenting with chemoradiotherapy. Herein, we...

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Bibliographic Details
Published inJournal of the Korean Society of Radiology Vol. 81; no. 5; pp. 1216 - 1221
Main Authors Cho, Joon Ho, Lee, Hyoung Nam
Format Journal Article
LanguageEnglish
Published The Korean Society of Radiology 01.09.2020
대한영상의학회
Subjects
chemoradiotherapy
embolization
Interventional Radiology
neoadjuvant therapy
pancreatic neoplasms
stents
therapeutic
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Summary:Neoadjuvant concurrent chemoradiotherapy has been increasingly used to obtain secondary resectability for locally advanced pancreatic cancers. Although most patients require biliary decompression, only a few studies have investigated the safety of biliary stenting with chemoradiotherapy. Herein, we report a rare case of delayed hemorrhage of the hepatic artery caused by biliary stenting after chemoradiotherapy. The serial follow-up CT demonstrated that the biliary stent was approaching the right hepatic artery and eventually caused acute angulation and indentation. Diagnostic catheter angiography revealed contrast extravasation at the right hepatic artery, and endovascular embolization was performed. This report highlights the relevance of anatomical deformation after chemoradiotherapy, which can result in fatal complications. Indentation of the hepatic artery caused by biliary stents should be recognized as a warning sign of vascular injury.
Bibliography:https://doi.org/10.3348/jksr.2019.0087
ISSN:1738-2637
2288-2928
2951-0805
DOI:10.3348/jksr.2019.0087