Mathuram Thiyagarajan Umasankar, Ponnuswamy Amirtha, Hindmarsh Andrew
Transplantation and Hepatobiliary-Pancreactic Surgery, University of Alberta Hospital, Edmonton, CAN.
Family Medicine, Epsom and St Helier Hospital NHS Trust, London, GBR.
Cureus. 2023 Jan 9;15(1):e33564. doi: 10.7759/cureus.33564. eCollection 2023 Jan.
Cystic artery pseudoaneurysm (CAP) is a very rare complication of acute cholecystitis. The pathogenesis of CAP in the context of cholecystitis is unknown but is possibly related to the inflammatory process in the vicinity of the cystic artery, leading to weakness in the wall of the artery. Though CAP has been reported in the literature, our patient had a unique presentation in the presence of a cholecystostomy catheter in situ. There were no risk factors for CAP in our patient including usage of anticoagulants, trauma, or surgical procedures. Fortunately, the blood-stained fluid in the cholecystostomy catheter effluent alerted the clinical team to a possible vascular complication in the background of ongoing cholecystitis. This finding should serve as a warning sign to alert clinicians to the possibility of CAP-beware of rattling underfoot.
胆囊动脉假性动脉瘤（CAP）是急性胆囊炎一种非常罕见的并发症。胆囊炎背景下CAP的发病机制尚不清楚，但可能与胆囊动脉附近的炎症过程有关，导致动脉壁薄弱。尽管文献中已有CAP的报道，但我们的患者在留置胆囊造瘘导管的情况下有独特的表现。我们的患者不存在CAP的危险因素，包括使用抗凝剂、创伤或外科手术。幸运的是，胆囊造瘘导管流出液中的血性液体提醒临床团队在持续胆囊炎背景下可能存在血管并发症。这一发现应作为一个警示信号，提醒临床医生注意CAP的可能性——小心脚下有“嘎嘎”声。
