慢性胆囊炎所致右肝动脉假性动脉瘤引起的胆道出血

Das Manjusha, Volmar Fritz-Henry, Walayat Saqib, Nolte Ryan

Division of Gastroenterology and Hepatology, College of Medicine, University of Illinois, Peoria, IL, USA.

Department of Internal Medicine, College of Medicine, University of Illinois, Peoria, IL, USA.

SAGE Open Med Case Rep. 2019 Aug 23;7:2050313X19872075. doi: 10.1177/2050313X19872075. eCollection 2019.

Splanchnic pseudoaneurysms are rare causes of hemobilia. Specifically, hepatic artery pseudoaneurysms from infectious or inflammatory etiology are even more rare. In this article, we describe our encounter with a 72-year-old female presenting with obstructive jaundice and acute blood loss anemia. Upper endoscopy indicated hemobilia and endoscopic retrograde cholangiopancreatography was completed with stent in place. Post endoscopic retrograde cholangiopancreatography, computed tomography angiogram indicated a right hepatic artery pseudoaneurysm which was the cause of her hemobilia. The patient was ultimately treated with selective coil embolization and interval cholecystectomy.

内脏假性动脉瘤是引起胆道出血的罕见原因。具体而言，由感染性或炎症性病因导致的肝动脉假性动脉瘤更为罕见。在本文中，我们描述了一名72岁女性患者，她因梗阻性黄疸和急性失血性贫血前来就诊。上消化道内镜检查显示有胆道出血，随后进行了内镜逆行胰胆管造影并放置了支架。内镜逆行胰胆管造影术后，计算机断层血管造影显示右肝动脉假性动脉瘤，这是导致她胆道出血的原因。该患者最终接受了选择性弹簧圈栓塞术和间隔期胆囊切除术。