Detection and treatment of an aneurysma spurium of the arteria hepatica dextra after laparoscopic cholecystectomy

BMC Gastroenterology

Bernd Krakamp²  Thomas Saers²  Andreas Scheding³  Oliver Kirschberg¹ 

[1] Department of Internal Medicine, HELIOS Klinik Wipperfuerth, Alte-Koelner-Strasse 9, Wipperfuerth D-51668, Germany;Department of Internal Medicine II, Witten/Herdecke University, Faculty of Health – School of Medicine, Campus Cologne-Merheim, Ostmerheimerstrasse 200, Cologne D-51109, Germany;Department of Internal Medicine, Gastroenterology and Diabetology, Vivantes Humboldt Klinikum, Am Nordgraben 2, Berlin D-13509, Germany

关键词: Laparoscopic cholecystectomy;    Upper gastrointestinal bleeding;    Arteria hepatica;    Aneurysma spurium;   

Others  :  857741
DOI  :  10.1186/1471-230X-13-121

 received in 2013-01-30, accepted in 2013-07-24,  发布年份 2013

【 摘 要 】

Background

Massive upper gastrointestinal hemorrhage can be the dominant symptom of decompensated liver cirrhosis, varices and ulcerations in the upper gastrointestinal tract. Postoperative complications are known to lead to these bleedings. Commonly, emergency endoscopy will be performed. Here we report of a patient with extensive bleeding caused by an aneurysma spurium of the arteria hepatica dextra induced by a laparoscopic cholecystectomy. The condition was diagnosed by the Doppler ultrasound scan of the liver.

Case presentation

Initially the source of the gastrointestinal bleeding was caused by an ulcus Dieulafoy in the jejunum which was stopped by clipping. Continous bleeding was observed and traced to a rare complication of a laparoscopic cholecystectomy due to a gallbladder empyema. After surgical intervention the patient developed an aneurysma spurium of the arteria hepatica dextra which was in communication with the small bowel. The successful treatment was performed by embolizing the aneurysma.

Conclusion

The reasons for gastrointestinal bleedings are manifold. This case presents a seldom cause of a gastrointestinal bleeding due to an aneurysma of the hepatic arteria. The successful embolization was performed to ultimately stop the bleeding.

【 授权许可】

   
2013 Kirschberg et al.; licensee BioMed Central Ltd.

【 图 表 】

【 参考文献 】

• [1]Moses V, Keshava SN, Wann VC, Joseph P, Sitaram V, 2: Cystic artery pseudoaneurysma after laparoscopic cholecystectomy presenting as haemobilia: a case report. Trop Gastroenterol 2008, 29:107-9.
• [2]Murata K, Oohashi Y, Takase K, Nakano T, Tameda Y, 1: A case of hemobilia after percutaneous liver biopsy treated by transcatheter arterial embolization with histoacryl. Am J Gastroenterol 1996, 91:160.
• [3]Willemsen PJ, Vanderveken ML, De Caluwe DO, Tielliu IF: Hemobilia: a rare complication of cholecystitis and cholecystolithiasis. Case report. Acta Chir Belg 1996, 96(2):93-4.
• [4]Osawa H, Mori Y, Inoue F: Case report: malignant haemobilia detected in the gallbladder—retrograde cholangiographic findings. Br J Radiol 1996, 69(817):79-81.
• [5]Burns L, Slakey DP: Laparoscopic management of massive hemobilia from an intrahepatic aneurysm. JSLS 2009, 13:60-3.
• [6]Pollono EN, Madoff DC, Spence SC, Suarez-Almazor ME: Multiple hepatic artery aneurysmas in a patient with systemic lupus erythematosus. Lupus 2009. Epub ahead of print