Massive upper gastrointestinal bleeding due to right hepatic artery pseudoaneurysm secondary to cholecystitis

Open Medicine ◽  
2013 ◽  
Vol 8 (5) ◽  
pp. 665-668
Author(s):  
K. Habib ◽  
G. Williams
Keyword(s):  
Gastrointestinal Bleeding ◽  
Hepatic Artery ◽  
Upper Gastrointestinal Bleeding ◽  
Japanese Literature ◽  
Biliary Tree ◽  
Artery Pseudoaneurysm ◽  
Right Hepatic Artery ◽  
Hepatic Artery Pseudoaneurysm ◽  
Upper Gastrointestinal Bleed ◽  
Upper Gastrointestinal

AbstractA literature trawl reveals a substantial number of reports on true visceral aneurysms, including the hepatic artery, but only a handful of cases of visceral pseudoaneurysms. The ones in relation to the biliary tree are associated with previous gall bladder surgery and can result in significant gastrointestinal bleeding. There are more than 10 reported cases of cystic artery pseudoaneurysms but a thorough search revealed only two cases in English (1,2) and perhaps one in Japanese literature of right hepatic artery pseudoaneurysm secondary to cholecystitis presenting as massive upper gastrointestinal bleed. We present a probable fourth case in a 52 year old woman with classical clinical/biochemical picture, typical radiological appearance and who underwent successful interventional radiological treatment of this condition.

scholarly journals Upper Gastrointestinal Bleeding due to Hemobilia

2016 ◽  
Vol 36 (1) ◽  
pp. 100-102
Author(s):  
Ritu Lamichhane ◽  
Binita G. Joshi ◽  
Nishant Wadhwa ◽  
Arun Gupta
Keyword(s):  
Gastrointestinal Bleeding ◽  
Hepatic Artery ◽  
Upper Gastrointestinal Bleeding ◽  
Liver Trauma ◽  
Right Hepatic Artery ◽  
Life Threatening ◽  
Pseudo Aneurysm ◽  
Life Threatening Complication ◽  
Trauma Ct ◽  
Upper Gastrointestinal

Haemobilia is one rare but potentially life threatening complication of delayed haemorrhage following liver trauma which occurs as a result of pathological communication between bile ducts and intra or extrahepatic vessels. We describe here a case of two year old child who presented with upper gastrointestinal bleeding and developed haemobilia in one month duration after blunt abdominal trauma. CT angiography revealed a right hepatic artery pseudo aneurysm as the cause of haemobilia and was successfully treated with right hepatic artery embolisation.J Nepal Paediatr Soc 2016;36(1):100-102.

scholarly journals A rare cause of upper gastrointestinal bleeding in pregnancy

2019 ◽  
Vol 2 (1) ◽  
pp. 13-14
Author(s):  
Chitchai Rattananukrom ◽  
Wuttiporn Manatsathi
Keyword(s):  
Gastrointestinal Bleeding ◽  
Hepatic Artery ◽  
Upper Gastrointestinal Bleeding ◽  
Rare Complication ◽  
Sudden Onset ◽  
Contrast Extravasation ◽  
Flip Flop ◽  
Right Hepatic Artery ◽  
Upper Gastrointestinal ◽  
In Pregnancy

A 29-year-old 11-week pregnant multigravida woman without previous medical history presentedwith sudden onset of hematemesis. This case illustrates the occurrence of a rare complication (rupture of pseudoaneurysm of right hepatic artery inside the biliary system), appearing as upper gastrointestinal bleeding in a pregnant woman. The cause of the rupture is presumably pregnancy-related. We would like to emphasize the presence of pseudoaneurysm of the hepatic artery as a rare cause of gastrointestinal bleeding in pregnancy.   Figure 1 and 2  CTA showed a lobulated contour of saccular aneurysmal dilatation at proximal right hepatic artery, measured about 3.5x3.2x1.6 cm in size and 2.6 mm in neck width; pseudoaneurysm is likely. There is perianeurysmal heterogeneously hyperdense non-enhancing lesion which shows flip-flop phenomenon, measured about 5.5x6.1x5.5 cm in size; Partially thrombosed pseudoaneurysm at proximal right hepatic artery is likely. This lesion causes stretching of the common hepatic artery and portal vein. Hyperdenselesion with flip-flop phenomenon is also seen within dilated bilateral IHD, CHD, CBD and gallbladder; Contrast extravasation into CHD, CBD, 1st, 2nd, 3rd, 4th part of duodenum and jejunum is detected in portovenous phase. hemobilia is suggested.    

scholarly journals Massive hemobilia caused by rupture of gastroduodenal artery pseudoaneurysm, a delayed complication of laparoscopic cholecystectomy: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Kurniawan Kurniawan ◽  
I Dewa Nyoman Wibawa ◽  
Gde Somayana ◽  
I Ketut Mariadi ◽  
I Made Mulyawan
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gastrointestinal Bleeding ◽  
Abdominal Trauma ◽  
Upper Gastrointestinal Bleeding ◽  
Rare Complication ◽  
Gastroduodenal Artery ◽  
Time Interval ◽  
Artery Pseudoaneurysm ◽  
History Of ◽  
Upper Gastrointestinal

Abstract Background Hemobilia is a rare cause of upper gastrointestinal bleeding that originates from the biliary tract. It is infrequently considered in diagnosis, especially in the absence of abdominal trauma or history of hepatopancreatobiliary procedure, such as cholecystectomy, which can cause arterial pseudoaneurysm. Prompt diagnosis is crucial because its management strategy is distinct from other types of upper gastrointestinal bleeding. Here, we present a case of massive hemobilia caused by the rupture of a gastroduodenal artery pseudoaneurysm in a patient with a history of laparoscopic cholecystectomy 3 years prior to presentation. Case presentation A 44-year-old Indonesian female presented to the emergency department with complaint of hematemesis and melena accompanied by abdominal pain and icterus. History of an abdominal trauma was denied. However, she reported having undergone a laparoscopic cholecystectomy 3 years prior to presentation. On physical examination, we found anemic conjunctiva and icteric sclera. Nonvariceal bleeding was suspected, but esophagogastroduodenoscopy showed a blood clot at the ampulla of Vater. Angiography showed contrast extravasation from a gastroduodenal artery pseudoaneurysm. The patient underwent pseudoaneurysm ligation and excision surgery to stop the bleeding. After surgery, the patient’s vital signs were stable, and there was no sign of rebleeding. Conclusion Gastroduodenal artery pseudoaneurysm is a rare complication of laparoscopic cholecystectomy. The prolonged time interval, as compared with other postcholecystectomy hemobilia cases, resulted in hemobilia not being considered as an etiology of the gastrointestinal bleeding at presentation. Hemobilia should be considered as a possible etiology of gastrointestinal bleeding in patients with history of cholecystectomy, regardless of the time interval between the invasive procedure and onset of bleeding.

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