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Open Access Case report

Acute paranoid psychosis as sole clinical presentation of hepatic artery thrombosis after living donor liver transplantation

Armin D Goralczyk1*, Volker Meier2, Giuliano Ramadori2, Aiman Obed1 and Thomas Lorf1

Author Affiliations

1 Department of General and Visceral Surgery, University Medical Center Göttingen, Göttingen, Germany

2 Department of Gastroenterology and Endocrinology, University Medical Center Göttingen, Göttingen, Germany

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BMC Surgery 2010, 10:7  doi:10.1186/1471-2482-10-7

Published: 22 February 2010

Abstract

Background

Hepatic artery thrombosis is a devastating complication after orthotopic liver transplantation often requiring revascularization or re-transplantation. It is associated with considerably increased morbidity and mortality. Acute cognitive dysfunction such as delirium or acute psychosis may occur after major surgery and may be associated with the advent of surgical complications.

Case presentation

Here we describe a case of hepatic artery thrombosis after living-donor liver transplantation which was not preceded by signs of liver failure but rather by an episode of acute psychosis. After re-transplantation the patient recovered without sequelae.

Conclusion

This case highlights the need to remain cautious when psychiatric disorders occur in patients after liver transplantation. The diagnostic procedures should not be restricted to medical or neurological causes of psychosis alone but should also focus vascular complications related to orthotopic liver transplantation.