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Case Reports
. 2016 May 24;2(2):20150423.
doi: 10.1259/bjrcr.20150423. eCollection 2016.

Cystic artery pseudoaneurysm secondary to acute cholecystitis: an unusual cause for haemobilia

Thomas Charles Hall  1 , Walter Sprenger De Rover  1 , Said Habib  1 , Maruti Kumaran  1
Affiliations
Case Reports

Cystic artery pseudoaneurysm secondary to acute cholecystitis: an unusual cause for haemobilia

Thomas Charles Hall et al. BJR Case Rep. .

Abstract

Pseudoaneurysm of the cystic artery is a rarely described cause of haemobilia. We report the unusual presentation of upper gastrointestinal haemorrhage due to a pseudoaneurysm of the cystic artery secondary to acute cholecystitis that was complicated by gallbladder perforation and liver abscess in an 88-year-old male. The original CT scan had demonstrated a high density focus in the gallbladder neck that was thought to represent a calculus. Selective embolization of the cystic artery resulted in cessation of the haemorrhage. Owing to the patient's frailty and comorbidities, he was not considered suitable for cholecystectomy. The case emphasizes the need for a high level of awareness of pseudoaneurysmal disease in association with inflammatory conditions.

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Figures

Figure 1.
Figure 1.
Portal venous phase CT scan. (a) Thick white arrow points to liver abscess; thin white arrow points to high density within the gallbladder. (b) Arterial phase 1 week later (arrow denotes the pseudoaneurysm).
Figure 2.
Figure 2.
Arterial phase maximum intensity projection of the pseudoaneurysm (denoted by the white arrow).
Figure 3.
Figure 3.
Selective catheterization of the cystic artery. Arrow indicates the pseudoaneurysm.
See this image and copyright information in PMC

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