Hemobilia and cystic artery stump pseudoaneurysm associated with liver abscess after a laparoscopic cholecystectomy: report of a case

Surgery Today
Yuen NakaseTakuya Miyagaki

Abstract

A 63-year-old woman was admitted for cholecystitis and underwent a laparoscopic cholecystectomy (LC). She experienced abdominal pain and hemobilia 11 days after the LC. Angiography was performed but it did not show any source of bleeding. Thereafter, at 27 days after LC, a repeat angiogram was performed which revealed a pseudoaneurysm (PA) arising from a cystic artery stump and an embolized PA sack. However, another PA arising from near the embolized PA and liver abscess was observed 4 days after embolization. The arterial collateral flow was evaluated by endovascular balloon occlusion of the right hepatic artery and it was embolized proximal and distal to the bleeding point. The embolization of the partial hepatic artery was effective for PA when packing the PA sack proved to be insufficient. In patients with liver cirrhosis or liver abscess who require an adequate arterial liver flow, it is important to evaluate the collateral arterial flow before hepatic artery embolization.

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Citations

Jan 1, 2011·Case Reports in Gastrointestinal Medicine·Fabio SansonnaRaffaele Pugliese
Mar 13, 2010·Journal of Vascular Surgery·Jared R Hylton, William C Pevec
May 10, 2011·Annals of Vascular Surgery·Cameron D AdkissonJustin H Nguyen
May 7, 2020·Surgical Case Reports·Takehiro AbikoSatoshi Hirano

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