Rapid Resolution of Cholangitic Abscess and Biliary Sepsis in a Liver Transplant Recipient after Hepatic Artery Revascularization
Hepatic arterial flow is paramount in preserving biliary integrity. We present an interesting clinical scenario of a liver transplant recipient with biliary anastomotic stricture who developed biliary abscess and sepsis after Endoscopic Retrograde Cholangiopancreatography. The abscess did not respon...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Case Reports in Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2016/1520849 |
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| author | Sushrut Trakroo Kamran Qureshi |
| author_facet | Sushrut Trakroo Kamran Qureshi |
| author_sort | Sushrut Trakroo |
| collection | DOAJ |
| description | Hepatic arterial flow is paramount in preserving biliary integrity. We present an interesting clinical scenario of a liver transplant recipient with biliary anastomotic stricture who developed biliary abscess and sepsis after Endoscopic Retrograde Cholangiopancreatography. The abscess did not respond to maximal medical management, percutaneous drainage, and adequate endoscopic biliary drainage. Clinically, patient continued to deteriorate and imaging identified hepatic artery stenosis which was treated with percutaneous intra-arterial stenting. Revascularization and perfusion of infected area led to rapid resolution of abscess and sepsis. This case emphasizes the anatomic basis of biliary ductal pathology. An important educational point is to understand that interrupted hepatic arterial supply can lead to biliary complications in liver transplant recipients and early correction of perfusion deficit should be pursued in such cases. In nonresolving hepatobiliary infections after liver transplantation, hepatic arterial compromise should be looked for and if present promptly treated. Reperfusion of biliary system in our patient led to improved antibiotics penetration, resolution of abscess and sepsis, and healing of biliary stricture. |
| format | Article |
| id | doaj-art-9e508eb9a0f24ea59e63f83a002bb036 |
| institution | OA Journals |
| issn | 2090-6943 2090-6951 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Transplantation |
| spelling | doaj-art-9e508eb9a0f24ea59e63f83a002bb0362025-08-20T02:18:32ZengWileyCase Reports in Transplantation2090-69432090-69512016-01-01201610.1155/2016/15208491520849Rapid Resolution of Cholangitic Abscess and Biliary Sepsis in a Liver Transplant Recipient after Hepatic Artery RevascularizationSushrut Trakroo0Kamran Qureshi1Department of Surgery, Temple University Hospital, Philadelphia, PA 19140, USASection of Gastroenterology and Hepatology, Temple University Lewis Katz School of Medicine, Philadelphia, PA 19140, USAHepatic arterial flow is paramount in preserving biliary integrity. We present an interesting clinical scenario of a liver transplant recipient with biliary anastomotic stricture who developed biliary abscess and sepsis after Endoscopic Retrograde Cholangiopancreatography. The abscess did not respond to maximal medical management, percutaneous drainage, and adequate endoscopic biliary drainage. Clinically, patient continued to deteriorate and imaging identified hepatic artery stenosis which was treated with percutaneous intra-arterial stenting. Revascularization and perfusion of infected area led to rapid resolution of abscess and sepsis. This case emphasizes the anatomic basis of biliary ductal pathology. An important educational point is to understand that interrupted hepatic arterial supply can lead to biliary complications in liver transplant recipients and early correction of perfusion deficit should be pursued in such cases. In nonresolving hepatobiliary infections after liver transplantation, hepatic arterial compromise should be looked for and if present promptly treated. Reperfusion of biliary system in our patient led to improved antibiotics penetration, resolution of abscess and sepsis, and healing of biliary stricture.http://dx.doi.org/10.1155/2016/1520849 |
| spellingShingle | Sushrut Trakroo Kamran Qureshi Rapid Resolution of Cholangitic Abscess and Biliary Sepsis in a Liver Transplant Recipient after Hepatic Artery Revascularization Case Reports in Transplantation |
| title | Rapid Resolution of Cholangitic Abscess and Biliary Sepsis in a Liver Transplant Recipient after Hepatic Artery Revascularization |
| title_full | Rapid Resolution of Cholangitic Abscess and Biliary Sepsis in a Liver Transplant Recipient after Hepatic Artery Revascularization |
| title_fullStr | Rapid Resolution of Cholangitic Abscess and Biliary Sepsis in a Liver Transplant Recipient after Hepatic Artery Revascularization |
| title_full_unstemmed | Rapid Resolution of Cholangitic Abscess and Biliary Sepsis in a Liver Transplant Recipient after Hepatic Artery Revascularization |
| title_short | Rapid Resolution of Cholangitic Abscess and Biliary Sepsis in a Liver Transplant Recipient after Hepatic Artery Revascularization |
| title_sort | rapid resolution of cholangitic abscess and biliary sepsis in a liver transplant recipient after hepatic artery revascularization |
| url | http://dx.doi.org/10.1155/2016/1520849 |
| work_keys_str_mv | AT sushruttrakroo rapidresolutionofcholangiticabscessandbiliarysepsisinalivertransplantrecipientafterhepaticarteryrevascularization AT kamranqureshi rapidresolutionofcholangiticabscessandbiliarysepsisinalivertransplantrecipientafterhepaticarteryrevascularization |