Computed Tomography in the Demonstration of Hepatic Pseudoaneurysm with Hemobilia

Foley, W D; Ll, Berland; Lawson, T L; Fe, Maddison

doi:10.1097/00004728-198012000-00023

Cited by 22 publications

(16 citation statements)

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“…Transarterial or percutaneous embolization is the treatment of choice for iatrogenic pseudoaneurysms of the hepatic artery and its branches. Surgery is an option of last resort due to high morbidity and mortality associated with operative intervention in this setting 1-3,9,11…”

Section: Discussionmentioning

confidence: 99%

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Hemobilia Due to Cystic Artery Pseudoaneurysm: A Rare Late Complication of Laparoscopic Cholecystectomy

Badillo

Darcy

Kushnir

2017

ACG Case Reports Journal

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We discuss a patient with late presentation of hemobilia following cholecystectomy, which is unusual because pseudoaneurysm caused by vascular injury during surgery typically presents soon after surgery. Endoscopic retrograde cholangiopancreatography revealed a large blood clot arising from the biliary orifice with subsequent computed tomography angiography diagnosing a large pseudoaneurysm in the region of the cystic artery adjacent to the cholecystectomy clips. Embolization was performed via direct percutaneous puncture of the pseudoaneurysm.

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Section: Discussionmentioning

confidence: 99%

“…It is a diagnostic challenge due to its rarity and various clinical presentations 1,2. Therefore, the clinician must a have high index of suspicion to quickly identify and treat the complication.…”

Section: Introductionmentioning

confidence: 99%

Hemobilia Due to Cystic Artery Pseudoaneurysm: A Rare Late Complication of Laparoscopic Cholecystectomy

Badillo

Darcy

Kushnir

2017

ACG Case Reports Journal

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“…Doppler ultrasound can be used to detect the pulsatile mass with blood flow into the biliary tracts [24]. Tumors, abscesses, and the location of aneurysms and pseudoaneurysms can be identified by abdominal CT [25]. Furthermore, contrast-enhanced magnetic resonance imaging can be used to demonstrate the correlation of blood flow with bile ducts to support the diagnosis of hemobilia [26].…”

Section: Discussionmentioning

confidence: 99%

Life-threatening hemobilia caused by hepatic pseudoaneurysm after T-tube choledochostomy: report of a case

Lee

Chen

et al. 2010

BMC Gastroenterol

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BackgroundHemobilia is a rare but lethal biliary tract complication. There are several causes of hemobilia which might be classified as traumatic or nontraumatic. Hemobilia caused by pseudoaneurysm might result from hepatobiliary surgery or percutaneous interventional hepatobiliary procedures. However, to our knowledge, there are no previous reports pertaining to hemobilia caused by hepatic pseudoaneurysm after T-tube choledochostomy.Case presentationA 65-year-old male was admitted to our hospital because of acute calculous cholecystitis and cholangitis. He underwent cholecystectomy, choledocholithotomy via a right upper quadrant laparotomy and a temporary T-tube choledochostomy was created. However, on the 19th day after operation, he suffered from sudden onset of hematemesis and massive fresh blood drainage from the T-tube choledochostomy. Imaging studies confirmed the diagnosis of pseudoaneurysm associated hemobilia. The probable association of T-tube choledochostomy with pseudoaneurysm and hemobilia is also demonstrated. He underwent emergent selective microcoils emobolization to occlude the feeding artery of the pseudoaneurysm.ConclusionsPseudoaneurysm associated hemobilia may occur after T-tube choledochostomy. This case also highlights the importance that hemobilia should be highly suspected in a patient presenting with jaundice, right upper quadrant abdominal pain and upper gastrointestinal bleeding after liver or biliary surgery.

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“…CT has been reported useful in the diagnosis of splenic (16,17), hepatic (18)(19)(20)(21)(22), superior mesenteric (23), and gastroduodenal (24) artery aneurysms and PAs. Sonography has likewise proved useful in the diagnosis of splenic (25), hepatic (26)(27)(28)(29)(30), superior mesenteric (31,32), and celiac (33) artery aneurysms and PAs.…”

Section: Discussionmentioning

confidence: 99%

Pseudoaneurysms Complicating Organ Transplantation: Roles of CT, Duplex Sonography, and Angiography

1989

Journal of Diagnostic Medical Sonography

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In a retrospective study of proved pseudoaneurysms (PAs) in 15 patients with transplanted organs (11 liver, three kidney, one pancreas), the results of computed tomography (CT), duplex sonography, and angiography were reviewed. Of the 15 cases of PA, eight occurred at the arterial anastomosis and seven were nonanastomotic. Three of the eight anastomotic PAs were caused by infection. Of the seven nonanastomotic PAs, four were caused by percutaneous biopsy, two were caused by infection, and one was of undetermined cause. In nine (60%) of the 15 patients the PAs were incidentally detected at imaging studies performed for other reasons. Diagnosis requires a high degree of suspicion. CT was performed in nine cases and duplex sonography in ten. The diagnosis of PA was made with CT in six (67%) patients and with duplex sonography in five (50%). CT and duplex sonography could not enable diagnosis when the PA was small, when the arterial anastomosis was not included in the field of study, or when enhancement with intravenously administered contrast material was suboptimal. Angiography depicted the PAs in all 15 patients. In three liver transplant recipients with gastrointestinal tract bleeding, the causative PAs were detected only with angiography.

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Computed Tomography in the Demonstration of Hepatic Pseudoaneurysm with Hemobilia

Cited by 22 publications

References 0 publications

Hemobilia Due to Cystic Artery Pseudoaneurysm: A Rare Late Complication of Laparoscopic Cholecystectomy

Hemobilia Due to Cystic Artery Pseudoaneurysm: A Rare Late Complication of Laparoscopic Cholecystectomy

Life-threatening hemobilia caused by hepatic pseudoaneurysm after T-tube choledochostomy: report of a case

Pseudoaneurysms Complicating Organ Transplantation: Roles of CT, Duplex Sonography, and Angiography

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