Spontaneous right hepatic artery branch gallbladder fistula revealed by haemobilia and upper cataclysmic gastrointestinal bleeding

Abstract

Spontaneous right hepatic artery branch gallbladder fistula is a rare condition. Our case reported a spontaneous fistula between the right branch of the hepatic artery and the gall bladder. It constitutes a rare cause of haemobilia. In fact, the most common aetiology of haemobilia is traumatic or iatrogenic secondary to hepatobiliary surgery or interventions. Diagnosis of vascular-biliary fistula is not easy. The gallbladder endoluminal clot can mimic a mass, as in our patient. Selective arterial angiography is helpful in identifying the source of gastrointestinal haemorrhage. It can demonstrate the presence of arteriobiliary fistula. The differential diagnosis is arterial pseudoaneurysm in the vicinity of the vessel. Mini-invasive treatment of this fistula constitutes the best treatment. We here report a case of haemobilia with upper cataclysmic gastrointestinal bleeding revealing a spontaneous fistula between the right branch of the hepatic artery and the gall bladder.

Haemobilia Secondary to Spontaneous Cystic Artery-Gallbladder Fistula: A Unique Gastrointestinal Anomaly

“…Spontaneous fistula formation between the cystic artery and gall bladder has rarely been reported in the medical literature. As seen in our patient, it may result in a rare cause of haemobilia [1][2][3]. Haemobilia comprises approximately 6% of all the causes of acute gastrointestinal bleeding [4].…”

A Case Report: Hepatic artery pseudoaneurysm causing life-threatening haemobilia

“…Unlike the early twentieth century, mycotic aneurysms are seldom seen nowadays due to early diagnosis and antibiotic treatment of infective endocarditis. Iatrogenic and traumatic causes, atherosclerosis, vasculitis, as sequelae of peri inflammation such as cholecystitis and pancreatitis are the most reported causes in the recent articles [3] , [4] , [5] .…”

Hemobilia from a right hepatic artery pseudoaneurysm due to chronic cholecystitis

“…1,2 These are most often due to iatrogenic or traumatic causes but may also develop as a sequela of periarterial inflammation, such as cholecystitis. 2–5…”