Radiology 1988 Oct;169(1):65-70

Pseudoaneurysms complicating organ transplantation: roles of CT, duple
sonography, and angiography

Tobben PJ, Zajko AB, Sumkin JH, Bowen A, Fuhrman CR, Skolnick ML, Bron KM,
Esquivel CO, Starzl TE
Department of Radiology, University of Pittsburgh School of Medicine, PA

Abstract 

In a retrospective study of proved pseudoaneurysms (PAs) in 15 patients with
transplanted organs (11 liver, three kidney, one pancreas), the results of
computed tomography (CT), duplex sonography, and angiography were reviewed. Of
the 15 cases of PA, eight occurred at the arterial anastomosis and seven were
nonanastomotic. Three of the eight anastomotic PAs were caused by infection. Of
the seven nonanastomotic PAs, four were caused by percutaneous biopsy, two were
caused by infection, and one was of undetermined cause. In nine (60%) of the 15
patients the PAs were incidentally detected at imaging studies performed for
other reasons. Diagnosis requires a high degree of suspicion. CT was performed
in nine cases and duplex sonography in ten. The diagnosis of PA was made with CT
in six (67%) patients and with duplex sonography in five (50%). CT and duplex
sonography could not enable diagnosis when the PA was small, when the arterial
anastomosis was not included in the field of study, or when enhancement with
intravenously administered contract material was suboptimal. Angiography
depicted the PAs in all 15 patients. In three liver transplant recipients with
gastrointestinal tract bleeding, the causative PAs were detected only with
angiography