de Blaauw I, Repelaer van Driel O J
Diaconessenhuis, afd. Chirurgie, Eindhoven.
Ned Tijdschr Geneeskd. 1999 Nov 20;143(47):2380-3.
A woman aged 38 displayed colicky pains and melaena two weeks after a laparoscopic cholecystectomy. The haemoglobin level was decreased, the serum hepatic enzyme levels were slightly increased. Diagnostic imaging examinations and finally, because of recurrent symptoms, an emergency laparotomy revealed a bleeding from a pseudoaneurysm of the proper hepatic artery next to the choledochus. The aneurysm was ligated. Seven months later the patient had no more symptoms. The possibility of haemobilia should be considered in every case of gastrointestinal bleeding after laparoscopic cholecystectomy.
