Semin intervent Radiol 2015; 32(02): 182-194
DOI: 10.1055/s-0035-1549377
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Iatrogenic Hepatopancreaticobiliary Injuries: A Review

Prasanti G. Vachhani
1  Department of Radiology, Johns Hopkins Hospital, Baltimore, Maryland
,
Alexander Copelan
2  Department of Diagnostic Radiology, William Beaumont Hospital, Royal Oak, Michigan
,
Erick M. Remer
3  Department of Abdominal Radiology, Cleveland Clinic, Cleveland, Ohio
,
Baljendra Kapoor
4  Department of Interventional Radiology, Cleveland Clinic, Cleveland, Ohio
› Author Affiliations
Further Information

Publication History

Publication Date:
28 May 2015 (online)

Abstract

Iatrogenic hepatopancreaticobiliary injuries occur after various types of surgical and nonsurgical procedures. Symptomatically, these injuries may lead to a variety of clinical presentations, including tachycardia and hypotension from hemobilia or hemorrhage. Iatrogenic injuries may be identified during the intervention, immediately afterwards, or have a delayed presentation. These injuries are categorized into nonvascular and vascular injuries. Nonvascular injuries include biliary injuries such as biliary leak or stricture, pancreatic injury, and the development of fluid collections such as abscesses. Vascular injuries include pseudoaneurysms, arteriovenous fistulas, dissection, and perforation. Imaging studies such as ultrasound, computed tomography, magnetic resonance imaging, and digital subtraction angiography are critical for proper diagnosis of these conditions. In this article, we describe the clinical and imaging presentations of these iatrogenic injuries and the armamentarium of minimally invasive procedures (percutaneous drainage catheter placement, balloon dilatation, stenting, and coil embolization) that are useful in their management.