Moses V, Keshava S N, Wann V Cornerstone, Joseph P, Sitaram V
Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India.
Trop Gastroenterol. 2008 Apr-Jun;29(2):107-9.
Cystic artery pseudoaneurysm which developed following a cholecystectomy and resulting in upper gastrointestinal bleeding is a rare entity, with only three cases described in the literature. We report the case of a 26-year old man who presented with upper gastrointestinal bleeding approximately three months after laparoscopic cholecystectomy. Emergency abdominal angiogram revealed a cystic artery stump pseudoaneurysm, with no evidence of active contrast extravasation. The pseudoaneurysm was coil embolised and the patient had no further bleeding episodes. In this situation an angiogram and embolisation rather than surgery is the preferred mode of management both in terms of diagnosis and treatment. The presence of a dilated cystic artery stump on angiogram following cholecystectomy is an "ominous sign", even in the absence of active extravasation of contrast.
胆囊切除术后发生的胆囊动脉假性动脉瘤并导致上消化道出血是一种罕见的情况，文献中仅描述了三例。我们报告一例26岁男性病例，该患者在腹腔镜胆囊切除术后约三个月出现上消化道出血。急诊腹部血管造影显示胆囊动脉残端假性动脉瘤，无活动性造影剂外渗迹象。对假性动脉瘤进行了弹簧圈栓塞，患者未再发生出血事件。在这种情况下，无论是在诊断还是治疗方面，血管造影和栓塞而非手术是首选的治疗方式。胆囊切除术后血管造影显示胆囊动脉残端扩张即使在没有造影剂活动性外渗的情况下也是一个“不祥之兆”。
