Delayed hemobilia due to hepatic artery pseudo-aneurysm: a pitfall of laparoscopic cholecystectomy

Alrajraji, Mawaddah; Nawawi, Abrar; Jamjoom, Reda; Qari, Yousef; Aljiffry, Murad

doi:10.1186/s12893-016-0175-9

Cited by 11 publications

(6 citation statements)

References 28 publications

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“…They are divided into two types: True aneurysms and pseudo-aneurysms like our case. GDA pseudo-aneurysms are generally secondary to acute or chronic pancreatitis, cholangitis, traumatic or iatrogenic causes [3–6]. All these factors were present in our case.…”

Section: Discussionmentioning

confidence: 65%

Ascending Cholangitis secondary to migrated embolization coil of gastroduodenal artery pseudo-aneurysm a case report

et al. 2017

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BackgroundGastroduodenalartery (GDA) pseudo-aneurysms are very rare. Their clinical importance lies in the eventuality of rupture, causing bleeding and ultimately exsanguination.Case presentationWe report the case of a man, with prior history of biliary surgery, presenting with haemobilia secondary to a rupture of GDA pseudo-aneurysm eroding the main bile duct. The patient was treated with coil embolization. This technique is considered to be safe. However, on the long term, some complications may occur. In our case, the patient presented with cholangitis subsequent to coil migration in the lower bile duct. This situation was managed using endoscopic retrograde cholangiopancreatography (ERCP) allowing coil extraction with favorable evolution.ConclusionsGDA pseudo-aneurysms are very rare. Bleeding, secondary to the rupture of these lesions, is a serious complication that could lead to death. Diagnosis and treatment of ruptured GDA pseudo-aneurysms rely on angiography. This method is considered to be safe. Cholangitis secondary to coil migration in the main bile duct is exceedingly rare,but remains an eventuality that physicians should be cognizant of.

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Section: Discussionmentioning

confidence: 65%

Ascending Cholangitis secondary to migrated embolization coil of gastroduodenal artery pseudo-aneurysm a case report

et al. 2017

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“…We found 97 eligible studies and a sum of 134 patients who presented with at least one symptomatic PA following LC during a 26-year period (1994–2020). [ 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 …”

Section: Resultsmentioning

confidence: 99%

Symptomatic pseudoaneurysms following laparoscopic cholecystectomy

Lampropoulos

Markopoulos²,

Tsochatzis

et al. 2021

Journal of Minimal Access Surgery

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Background: Laparoscopic cholecystectomy (LC) has been associated with an increase in the incidence of biliary and vascular injuries. Pseudoaneurysms (PAs) following LC are rare life-threatening events with limited available experience regarding diagnosis and treatment. Materials and Methods: An extensive review of literature during a 26-year period (1994–2020) using MEDLINE ® database and Google Scholar ® academic search engine revealed 134 patients with at least one symptomatic PA following LC. Results: Nearly 81% of patients with PAs become symptomatic during the first 8 weeks following LC. The most common symptoms were gastrointestinal bleeding (74%) and abdominal pain (61%). In 28% of cases, there was a concomitant bile duct injury or leak from the cystic duct stump, whereas in about one-third of cases, PAs presented following an uneventful LC. The most common involved arteries were the right hepatic artery (70%), the cystic artery (19%) or both of them (3%). Trans-arterial embolisation was the favoured first-line treatment with a success rate of 83%. During a median follow-up of 9 months, the mortality rate was 7%. Conclusion: Clinicians should be aware of the PA occurrence following LC. Prompt diagnosis and treatment are essential.

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“…To investigate the cause of hemobilia after LC, a PubMed search was conducted. After searching for keywords such as "Hemobilia," "Postoperative," and "Laparoscopic cholecystectomy," 16 case reports (29 cases) were found [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] (Table 2). In these Fig.…”

Section: Discussionmentioning

confidence: 99%

Hemobilia-a rare complication after laparoscopic cholecystectomy-

Abiko¹,

Ebihara

Takeuchi³

et al. 2020

surg case rep

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Background: Biliary bleeding is a condition reported by Sandblom as hemobilia. The most common cause of hemobilia is iatrogenicity. But it has also been reported as a rare complication after laparoscopic cholecystectomy (LC). Case presentation: A man in his 60s underwent a LC. He was taking a direct Xa inhibitor for paroxysmal atrial fibrillation (pAf) and had a history of thrombectomy. There was variation in the bifurcation of the hepatic artery and cystic artery. The right hepatic artery branches from the common hepatic artery by itself, and the cystic artery is double. He complained of right upper quadrant pain, nausea, and vomiting on the third postoperative day (3POD). Noncontrast computed tomography (CT) showed that a high absorption area was found to fill the common bile duct. Contrast CT showed no pseudoaneurysm formation. Ultimately, he was diagnosed with postoperative hemobilia. Angiographic examination selective for the cystic artery branching from the middle hepatic artery revealed leakage of the contrast agent and a micro-pseudoaneurysm. Conclusions: We encountered a case of hemobilia after LC. In this case, it was presumed that in addition to the chronic inflammatory changes of the gallbladder wall, extraordinary bifurcation of the hepatic artery and the cystic arteries and easy bleeding due to resumption of a direct Xa inhibitor synergistically caused a micro-pseudoaneurysm and postoperative hemobilia. It was difficult to identify the cause of hemobilia by contrast CT alone. Angiographic examination was useful for identifying and treating the causative artery and needs to perform aggressively.

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Delayed hemobilia due to hepatic artery pseudo-aneurysm: a pitfall of laparoscopic cholecystectomy

Cited by 11 publications

References 28 publications

Ascending Cholangitis secondary to migrated embolization coil of gastroduodenal artery pseudo-aneurysm a case report

Ascending Cholangitis secondary to migrated embolization coil of gastroduodenal artery pseudo-aneurysm a case report

Symptomatic pseudoaneurysms following laparoscopic cholecystectomy

Hemobilia-a rare complication after laparoscopic cholecystectomy-

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