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Multiple intrahepatic artery aneurysms during the treatment for IgG4-related sclerosing cholangitis: A case report.

World J Hepatol

December 2024

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan.

Article Synopsis
  • The case report discusses a 64-year-old woman with IgG4-related sclerosing cholangitis who developed multiple intrahepatic artery aneurysms while on treatment.
  • Emergency procedures successfully treated the aneurysms, resolving her symptoms and stabilizing her condition.
  • The report highlights that hepatic artery aneurysms can be serious complications in patients with IgG4-SC, indicating a need for vigilant monitoring.
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Article Synopsis
  • Pseudoaneurysms can occur after hepatobiliary and pancreatic surgeries, and catheter interventions are typically the first step in treatment; however, complications from arterial embolization can arise.
  • A case study of a 43-year-old male revealed that a dislodged embolization coil caused bile duct stone formation, leading to recurrent cholangitis after previous treatment for a hepatic artery pseudoaneurysm.
  • The case highlights the need for clinicians to monitor embolization coil positions in patients and consider coil migration as a potential cause when diagnosing bile duct stones, especially following hepatic artery embolization.
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A 69-year-old man underwent liver transplantation with a deceased donor for cirrhosis secondary to steatohepatitis. The arterial anastomosis was performed between the celiac trunk of the donor and the hepatic artery of the recipient. In the second postoperative month, he developed abdominal pain and abnormal liver function tests.

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Congenital portosystemic shunts (CPSS) are rare pediatric vascular malformations characterized by abnormal development of the portal vein, which is attributed to incomplete embryonic remodeling of the hepatic and surrounding vasculature. CPSS manifests in two main forms: intrahepatic and extrahepatic. This study details the management of a pediatric patient diagnosed with Congenital Intrahepatic Portosystemic Shunt (CIPS) who was referred to our institution.

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Article Synopsis
  • Endoscopic ultrasound (EUS) has transitioned from being solely a diagnostic tool to an interventional method that allows for precise treatment options, particularly in vascular access and therapy related to liver diseases.* -
  • EUS-guided procedures, like measuring portal pressure gradients and sampling portal venous blood, play a key role in diagnosing and managing various cancers and liver conditions, such as hepatocellular carcinoma and portal vein tumor thrombus.* -
  • The application of EUS is expanding to include treatments for complications like pseudoaneurysms and gastrointestinal bleeding, highlighting its growing importance in modern medical practice for both current and future therapeutic interventions.*
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