Hepatic artery pseudoaneurysm associated with cholecystitis that ruptured into the gallbladder

Journal of Gastroenterology
Tomotaka AkatsuMasaki Kitajima

Abstract

Pseudoaneurysm of the hepatic artery due to cholecystitis may be very rare, and in our survey of the literature, the present case report is the first case of such a pseudoaneurysm. A 64-year-old woman presented with upper gastrointestinal bleeding and severe epigastric pain. Upper gastrointestinal tract endoscopy revealed blood coming out of the papilla of Vater. Color-Doppler ultrasound imaging showed a pulsatile wave pattern in an echogenic lesion inside the gallbladder. Contrast-enhanced computed tomography demonstrated a 3-cm pseudoaneurysm in the distended gallbladder. Angiography disclosed extravasation originating from the right hepatic artery. Emergency selective transcatheter arterial embolization was performed, with intravascular stainless steel microcoils, and complete occlusion of the pseudoaneurysm was achieved. The patient underwent cholecystectomy with resection of the extrahepatic bile duct and biliary reconstruction in a Roux-en-Y fashion. Macroscopically, the resected gallbladder contained clotted blood and multiple cholesterol stones. Microscopically, the mucosa of the gallbladder showed extensive necrosis and many inflammatory cells. The final diagnosis was pseudoaneurysm of the hepatic artery associated wit...Continue Reading

Citations

Dec 1, 2013·Clinical Journal of Gastroenterology·Satoshi SuzukiAkio Takada
Jul 7, 2010·Journal of the Chinese Medical Association : JCMA·Yen-Huai LinCheng-Yen Chang
Jun 30, 2009·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Shan-Zu LinChun-Chia Chen
Dec 30, 2008·Gastroentérologie Clinique Et Biologique·H T SousaM C Leitão
Jan 30, 2009·Transplant International : Official Journal of the European Society for Organ Transplantation·Nicholas OnacaMarlon F Levy
Mar 8, 2006·Journal of Vascular Surgery·John HarveyFrank DeBernardis
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Dec 17, 2010·World Journal of Hepatology·Kazuhisa TakedaHiroshi Shimada
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Sep 7, 2019·SAGE Open Medical Case Reports·Manjusha DasRyan Nolte
Mar 14, 2020·ANZ Journal of Surgery·Elizabeth LockieBenjamin Thomson

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