Cystic Artery Hemorrhage after Cholecystostomy Catheter Exchange Treated with Transcatheter Embolization

Abstract

The pathogenesis of formation of cystic artery pseudoaneurysms is not well understood, but is thought to result from erosion of the cystic artery wall from the adjacent inflammatory process associated with acute or chronic cholecystitis. The presented case discusses an incident of hemorrhage from a cystic artery pseudoaneurysm resulting in a large perihepatic hematoma as well as hemobilia, which developed after a routine cholecystostomy catheter exchange. This was treated with transcatheter embolization using ethylene-vinyl alcohol copolymer.

Keywords

hemorrhage - gallbladder - cholecystitis - cholecystostomy - pseudoaneurysm - interventional radiology

Financial Disclosure

None.

• References

• 1 Mokrane FZ, Alba CG, Lebbadi M. , et al. Pseudoaneurism of the cystic artery treated with hyperselective embolisation alone. Diagn Interv Imaging 2013; 94 (06) 641-643
• 2 Hall TC, Sprenger De Rover W, Habib S, Kumaran M. Cystic artery pseudoaneurysm secondary to acute cholecystitis: an unusual cause for haemobilia. BJR Case Rep 2016; 2 (02) 20150423
• 3 Fujimoto Y, Tomimaru Y, Hatano H. , et al. Ruptured cystic artery pseudoaneurysm successfully treated with urgent cholecystectomy: a case report and literature review. Am J Case Rep 2018; 19: 187-193
• 4 Maddineni S, , D Lim MM, McCabe S, Rozenblit G. Transcatheter embolization of a cystic artery pseudoaneurysm in a cirrhotic patient with perforated acute cholecystitis. Indian J Radiol Imaging 2017; 27 (04) 521-523
• 5 Tapnio RH, Kolber MK, Shukla PA, Berkowitz E. Transcatheter embolization of cystic artery pseudoaneurysms secondary to acute cholecystitis. Vasc Endovascular Surg 2017; 51 (07) 498-500