Barba C A, Bret P M, Hinchey E J
Department of Surgery, McGill University, Montreal, Que.
Can J Surg. 1994 Feb;37(1):64-6.
Aneurysms are a rare cause of hemobilia. The arteries most frequently involved are branches of the hepatic or gastroduodenal arteries. The authors report the case of a patient with hemobilia secondary to a pseudoaneurysm of the cystic artery. Only six other cases have been reported in the literature, and in all of them the condition was associated with inflammation of the gallbladder. Selective hepatic arteriography is the procedure of choice for diagnosis. Colour-Doppler ultrasonography aided in the diagnosis in the patient described in this report and may prove to be useful in equivocal cases. Cholecystectomy and ligation of the cystic artery with proximal control of the hepatic artery should be performed as soon as the diagnosis is made.
动脉瘤是胆道出血的罕见病因。最常受累的动脉是肝动脉或胃十二指肠动脉的分支。作者报告了一例继发于胆囊动脉假性动脉瘤的胆道出血患者。文献中仅另有6例报道，且所有病例均与胆囊炎有关。选择性肝动脉造影是诊断的首选方法。彩色多普勒超声有助于本报告中所述患者的诊断，在不明确的病例中可能证明是有用的。一旦确诊，应立即行胆囊切除术并结扎胆囊动脉，同时近端控制肝动脉。
