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Pseudoaneurysm of the Cystic Artery Secondary to Cholecystitis as a Cause of Hemobilia: Report of a Case

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Abstract

Spontaneous intracholecystic bleeding is very rare. We report herein a very rare case of a pseudoaneurysm of the cystic artery due to acute cholecystitis. A 58-year-old man presented at the emergency department complaining of colicky pain in the right upper quadrant. Dynamic magnetic resonance imaging demonstrated an early-enhanced pooling of contrast material (suggestive of a pseudoaneurysm of the cystic artery) inside the neck of the gallbladder. After the proximal control of the hepatic artery, the patient underwent a cholecystectomy and a ligation of the cystic artery. The resected specimen of the gallbladder showed evidence of a massive intracholecystic hematoma. Proximal to the impacted gallstone in the neck, a 2-cm diameter saccular-type pseudoaneurysm was identified. Although a pseudoaneurysm of the cystic artery is very rare, it should be included in the differential diagnosis of hemobilia. Once the pseudoaneurysm is confirmed, its embolization before a cholecystectomy (which can be attempted laparoscopically) may be useful to ensure the safety of the patient.

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Authors and Affiliations

  1. Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan

    Tomotaka Akatsu, Minoru Tanabe, Tomohiro Shimizu, Kan Handa, Shigeyuki Kawachi, Koichi Aiura, Masakazu Ueda, Motohide Shimazu & Masaki Kitajima

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  1. Tomotaka Akatsu
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  2. Minoru Tanabe
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  3. Tomohiro Shimizu
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  4. Kan Handa
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Akatsu, T., Tanabe, M., Shimizu, T. et al. Pseudoaneurysm of the Cystic Artery Secondary to Cholecystitis as a Cause of Hemobilia: Report of a Case. Surg Today 37, 412–417 (2007). https://doi.org/10.1007/s00595-006-3423-2

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  • DOI: https://doi.org/10.1007/s00595-006-3423-2

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