Bezold Amy, Tran Xuan, Edhayan Gautam, Javaid Uzair, Shestopalov Alexander
Vascular and Interventional Radiology, Oregon Health and Science University, Portland, USA.
Radiology, University of Texas Medical Branch, Galveston, USA.
Cureus. 2024 Dec 4;16(12):e75116. doi: 10.7759/cureus.75116. eCollection 2024 Dec.
Cystic artery pseudoaneurysms are a rare but life-threatening entity that commonly occurs as a sequela to acute cholecystitis. We present a case of a 52-year-old male with a past medical history of decompensated alcoholic liver cirrhosis who underwent a transjugular liver biopsy (TJLB) after correction of his baseline coagulopathy. On post-operative day one, the patient had significant blood loss with an inappropriate response to blood transfusions and without an identifiable source of bleeding. Imaging was obtained, which revealed findings for concerning active hemorrhage into the gallbladder lumen. Angiography was performed, demonstrating a cystic artery pseudoaneurysm with resultant bleeding into the gallbladder, necessitating intervention. The patient underwent successful endovascular embolization of the superior and inferior divisions of the distal cystic artery using multiple metallic coils. The patient was discharged after six days post-operatively without further incident. Follow-up imaging demonstrated no residual filling of the cystic artery pseudoaneurysm. This case highlights an important, albeit rare, complication of TJLB that interventionalists should be aware of due to its rarity and the potential for significant morbidity.
胆囊动脉假性动脉瘤是一种罕见但危及生命的疾病，通常是急性胆囊炎的后遗症。我们报告一例52岁男性，既往有失代偿期酒精性肝硬化病史，在纠正基线凝血功能障碍后接受了经颈静脉肝活检（TJLB）。术后第一天，患者出现大量失血，对输血反应不佳，且未发现明确的出血源。进行了影像学检查，结果显示胆囊腔内有活动性出血的迹象。进行了血管造影，显示胆囊动脉假性动脉瘤并导致胆囊出血，需要进行干预。患者使用多个金属线圈成功地对远端胆囊动脉的上下分支进行了血管内栓塞。患者术后六天出院，无进一步事件发生。随访影像学检查显示胆囊动脉假性动脉瘤无残留充盈。该病例突出了TJLB一种重要的并发症，尽管罕见，但由于其罕见性和显著发病的可能性，介入医生应予以关注。
