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Case Reports
. 2019 Feb 26;13(1):89-94.
doi: 10.1159/000497097. eCollection 2019 Jan-Apr.

Hemobilia Derived from Cystic Artery Pseudoaneurysm

Takayuki Tanaka  1 , Kazuki Takakura  1 , Yuki Maruyama  1 , Akihisa Hidaka  1 , Masanori Nakano  1 , Yuichi Torisu  1 , Masayuki Saruta  1
Affiliations
Case Reports

Hemobilia Derived from Cystic Artery Pseudoaneurysm

Takayuki Tanaka et al. Case Rep Gastroenterol. .

Abstract

Cystic artery pseudoaneurysm (CAP) is a rare disease, with small number of previous reports related to CAP. Besides, it is frequently prone to critical condition due to arterial bleeding. Here, we presented a case of ruptured CAP with acute calculus cholecystitis and its subsequent successful management with temporary endoscopic biliary drainage for obstructive jaundice and embolization for the culprit artery without cholecystectomy. Since CAP is at high risk of bleeding, intravascular treatment, which is only one currently available therapeutic option, is urgently required in the clinical sites.

Keywords: Cholecystitis; Cystic artery pseudoaneurysm; Embolization; Hemobilia; Rupture.

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Figures

Fig. 1
Fig. 1
Abdominal CT showing the cystic artery pseudoaneurysm (a) and hemobilia into the common bile duct and gallbladder stone (b).
Fig. 2
Fig. 2
Endoscopic retrograde cholangiography showing dilatation of the common bile duct and a plastic stent (10 Fr, 5 cm) for drainage.
Fig. 3
Fig. 3
a, b Endoscopy showing the hemorrhage from the papilla of Vater.
Fig. 4
Fig. 4
Angiography showing the cystic artery pseudoaneurysm before embolization (a) and after embolization (disappeared) (b).
See this image and copyright information in PMC

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