Pseudoaneurysm of the Hepatic Artery Presenting with Hemobilia – a Complication of Laparoscopic Cholecystectomy

Česká verzia

Authors: K. Schwarzmannová ¹; T. Poch ¹; J. Šimša ¹; T. Vidim ¹; P. Chudomel ¹; P. Volšanský ²; S. Kašík ³; M. Chochola ⁴
Authors place of work: Chirurgické oddělení Oblastní nemocnice Kolín, a. s., primář: doc. MUDr. J. Šimša, Ph. D. ¹; Endoskopické centrum Oblastní nemocnice Kolín, a. s., primář: MUDr. P. Volšanský ²; Radiodiagnostické oddělení Oblastní nemocnice Kolín, a. s., primář: MUDr. S. Kašík ³; Angiocentrum Kolín, a. s., vedoucí lékař: MUDr. P. Kudrna ⁴
Published in the journal: Rozhl. Chir., 2008, roč. 87, č. 7, s. 360-363.
Category: Monothematic special - Original

Summary

Introduction:
Hemobilia, defined as a bleeding into the bile duct, is a rare disease. One of its infrequent causes is a hepatic artery pseudoaneurysm, usually developed after arterial iatrogenic leasion.

Material and methods:
A case review, presenting right hepatic artery pseudoaneurysm with a biliovascular fistula as a consequence of hepatic artery and bile duct injuries during „uncomplicated“ laparoscopic cholecystectomy.

Discussion:
Bile duct injury is one of the most serious complication after laparoscopic cholecystectomy. Hepatic artery may be injured simultaneously, resulting in the pseudoaneurysm and/or biliovascular fistula, presenting with hemobilia. Time interval from the injury to symptoms widely varies from few hours to weeks or even several months.

Conclusion:
Melena or hematemesis after recent laparoscopic cholecystectomy should be always suspicious from hepatic artery and/or bile duct injuries, manifesting with hemobilia.

Key words:
laparoscopic cholecystectomy – complication – pseudoaneurysm – biliovascular fistula – hemobilia – embolisation – stent

Zdroje

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