Mate Ajay D, Surnare Kailas R, Deolekar Samir S, Gvalani Anil K
Department of Surgery, Seth G. S. Medical College, K. E. M. Hospital, Parel, Mumbai, Maharashtra, India.
J Minim Access Surg. 2013 Jan;9(1):31-3. doi: 10.4103/0972-9941.107135.
Pseudoaneurysm of hepatic artery is a rare but known complication of laparoscopic cholecystectomy (LC). Such pseudoaneurysms may bleed in biliary tree, upper gastrointestinal (GI) tract or peritoneal cavity leading to life-threatening internal haemorrhage. It is very rare for them to present as lower GI bleeding. We report an unusual case of Right hepatic artery pseudoaneurysm developed following LC, which ruptured into hepatic flexure of colon resulting in catastrophic lower GI bleeding. This was associated with partial celiac artery occlusion due to thrombosis. Due to failure of therapeutic embolisation, the patient was subjected to exploratory laparotomy to control haemorrhage. Postoperatively, patient recovered well and was discharged on postoperative day 10. A strong index of suspicion is necessary for early diagnosis of such condition and to limit resultant morbidity. Angioembolisation is the first-line treatment and surgery is indicated in selected cases.
肝动脉假性动脉瘤是腹腔镜胆囊切除术（LC）一种罕见但已知的并发症。此类假性动脉瘤可能在胆道、上消化道（GI）或腹腔内出血，导致危及生命的内出血。它们表现为下消化道出血极为罕见。我们报告一例不寻常的病例，患者在LC术后发生右肝动脉假性动脉瘤，该动脉瘤破裂至结肠肝曲，导致灾难性的下消化道出血。这与因血栓形成导致的腹腔干部分闭塞有关。由于治疗性栓塞失败，患者接受了剖腹探查术以控制出血。术后，患者恢复良好，于术后第10天出院。对此类情况进行早期诊断并限制由此产生的发病率，必须要有高度的怀疑指数。血管栓塞是一线治疗方法，在特定病例中需进行手术治疗。
