A Challenging Case of Postcholecystectomy Pseudoaneurysm at an Uncommon Location

Hepatic artery pseudoaneurysm in postcholecystectomy choleduodenal fistula is an extremely rare but clinically significant complication. A 52-year-old male presented with hematemesis and melena several weeks after open cholecystectomy for complicated gallstone disease. Upper gastrointestinal endosco...

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Bibliographic Details
Main Authors: Shayeri Roy Choudhary, Harish Bhujade, Pankaj Gupta, Harjeet Singh, Naveen Kalra, Mandeep Kang
Format: Article
Language:English
Published: Thieme Medical Publishers, Inc. 2023-04-01
Series:Journal of Clinical Interventional Radiology ISVIR
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1742728
Description
Summary:Hepatic artery pseudoaneurysm in postcholecystectomy choleduodenal fistula is an extremely rare but clinically significant complication. A 52-year-old male presented with hematemesis and melena several weeks after open cholecystectomy for complicated gallstone disease. Upper gastrointestinal endoscopy revealed bleeding from the choledochoduodenal fistula site. On computed tomography angiography, a small right hepatic artery pseudoaneurysm close to fistula site was identified. Endovascular embolization failed due to nonopacification of the proximal right hepatic artery. Endoscopic ultrasound-guided embolization was also unsuccessful due to the small size of the aneurysm and inadequate visualization. Following this, percutaneous n-butyl cyanoacrylate glue was successfully injected into the pseudoaneurysm. The patient recovered and was planned for hepaticojejunostomy to restore biliary continuity.
ISSN:2456-4869