Haemobilia due to hepatic artery pseudoaneurysm

BMJ Case Rep. 2017 May 29:2017:bcr2017220575. doi: 10.1136/bcr-2017-220575.

Abstract

An 83-year-old woman with a history of hepaticoduodenostomy 20 years ago was admitted with upper gastrointestinal bleeding. Emergency upper gastrointestinal endoscopy revealed multiple blood clots over the stomach and first and second parts of the duodenum. The cannulation of the biliary tree with a flexible end-viewing endoscope exposed the presence of blood clot inside biliary lumen and a semipedunculated polyp which, at first, appeared to be the cause of haemorrhage. A few days after polypectomy, patient was discharged home, however, was admitted again with massive bleeding and selective angiography demonstrated a pseudoaneurysm of left hepatic artery. Angioembolisation was performed and haemorrhage was stopped afterwards.

Keywords: GI bleeding; Interventional radiology.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Aneurysm, False / complications*
  • Aneurysm, False / pathology
  • Angiography / methods
  • Diagnosis, Differential
  • Embolization, Therapeutic / methods
  • Endoscopy, Gastrointestinal / methods
  • Female
  • Gastrointestinal Hemorrhage / etiology*
  • Gastrointestinal Hemorrhage / pathology
  • Hemobilia / complications
  • Hemobilia / diagnosis*
  • Hemobilia / etiology
  • Hepatic Artery / diagnostic imaging
  • Hepatic Artery / pathology*
  • Humans
  • Treatment Outcome
  • Upper Gastrointestinal Tract / diagnostic imaging