While the liver parenchyma has a dual blood supply from the portal vein and hepatic artery, the biliary tree is exclusively supplied arterially. Also, the biliary epithelium is more prone to ischemia compared to hepatocytes.
In this case, due to thrombosis of the aortic conduit, hepatic arterial supply was shut off, bare some minor collateral arteries via the GDA. Biliary avascular necrosis with abscess formation occurred.
The management of this patient consists of:
- Placement on the urgent liver transplant list
- Radiological catheter drainage of the right lobe of liver collection
Related articles: Hepatic artery resistive index, Liver abscess