RESUMO
BACKGROUND: Hepatic artery pseudoaneurysm after liver transplantation is a rare condition that can lead to spontaneous bleeding, depending on its extent and location. Treatment involves endovascular and surgical approaches in addition to liver retransplantation in cases of graft failure. CASE REPORT: A 42-year-old female underwent deceased donor liver transplantation due to cryptogenic cirrhosis and schistosomiasis with an uneventful postoperative course. However, 18 days after the operation, she presented to the emergency department with abdominal pain, hypotension, and lipothymia. A computed tomography scan revealed a hepatic artery anastomotic pseudoaneurysm, and due to hemodynamic instability, emergency laparotomy was indicated. During the operation, the pseudoaneurysm was found to be ruptured, and the recipient's hepatic artery was ligated due to life-threatening bleeding. She later developed ischemic cholangiopathy and biliary complications, eventually undergoing retransplantation 7 months after the emergency operation. The patient remains well 11 months after the retransplantation. CONCLUSION: We report a rare case of life-threatening rupture of hepatic artery pseudoaneurysm, which required emergency ligation of the recipient's hepatic artery and subsequent liver retransplantation due to biliary complications.
RESUMO
A hipertensão arterial sistêmica e o diabetes mellitus são doenças de caráter crônico e degenerativo associadas a inúmeras complicações, agudas e crônicas, de alto potencial em morbimortalidade, sendo um grande problema de saúde pública. No presente projeto, propõe-se a implantação de um grupo permanente de educação e intervenção em hipertensão arterial sistêmica e diabetes mellitus na Unidade de Saúde da Família do Alto da Terezinha em Salvador-BA. Serão realizadas atividades semanais em grupo com pacientes identificados pela equipe de saúde que possuem dificuldades na adesão e no controle da PA e/ou glicemia. Com a ação proposta espera-se melhorar a adesão dos pacientes hipertensos e diabéticos às medidas farmacológicas e não farmacológicas propostas no plano terapêutico, e assim aumentar o alcance de controle dos níveis pressóricos e glicêmicos e, consequentemente, reduzir a ocorrências das complicações agudas e crônicas.
