Luc Tran Quang, Thao Bui-Thi Phuong, Nghia Nguyen-Van, My Thieu-Thi Tra, Quang Pham Vinh, Duc Nguyen Minh
Department of Radiology, Phu Tho Provincial General Hospital, Phu Tho, Vietnam.
Department of Radiology, Vinmec Times City International General Hospital, Hanoi, Vietnam.
Radiol Case Rep. 2024 Jun 15;19(9):3688-3692. doi: 10.1016/j.radcr.2024.05.065. eCollection 2024 Sep.
Gastrointestinal bleeding due to hemobilia is a rare condition but can be very serious, even life-threatening. The main causes of biliary bleeding are invasive procedures in treatment, trauma, or malignant diseases. Chronic obstruction of the biliary tract can cause inflammation, erosion, and leakage of adjacent vascular structures and lead to pseudoaneurysm or hemorrhage, but this is very rare. In this article, we present a clinical case of upper gastrointestinal bleeding due to a pseudoaneurysm of the hepatic artery believed to have formed due to chronic cholangitis. An 81-year-old female patient with a medical history of chronic cholangitis was admitted to the hospital with recurrent inflammation accompanied by progressive upper gastrointestinal bleeding, potentially life-threatening. Ultrasound images and blood tests confirmed that the patient had anemia and cholangitis caused by stones. Gastrointestinal endoscopy showed bleeding suspected to be from the biliary tract. Hepatobiliary computed tomography confirmed that the common hepatic artery pseudoaneurysm located at the upper end of the common bile duct had active bleeding.
胆血症所致的胃肠道出血是一种罕见病症，但可能非常严重，甚至危及生命。胆道出 血的主要原因是治疗中的侵入性操作、外伤或恶性疾病。胆道慢性梗阻可引起炎症、 邻近血管结构的侵蚀和渗漏，并导致假性动脉瘤或出血，但这种情况非常罕见。在本 文中，我们呈现了一例因肝动脉假性动脉瘤导致上消化道出血的临床病例，该假性动 脉瘤据信是由慢性胆管炎形成的。一名有慢性胆管炎病史的81岁女性患者因反复炎症 伴进行性上消化道出血（可能危及生命）入院。超声图像和血液检查证实患者患有贫 血和结石引起的胆管炎。胃肠内镜检查显示出血疑似来自胆道。肝胆计算机断层扫描 证实位于胆总管上端的肝总动脉假性动脉瘤有活动性出血。
