Hemobilia secondary to hepatic artery pseudoaneurysm:An unusual complication of bile leakage in a pa

• 作 者: Dimitrios Siablis Zafiria G. Papathanassiou Dimitrios Karnabatidis Nikolaos Christeas Constantine Vagianos
• 机 构: Department of Interventional Radiology,Medical School,University of Patras,Rio,Greece“,”Department o
• 出 处: 世界胃肠病学杂志(英文版)
• 发表日期: 2005年33期
• 关键词: Hepatic artery pseudoaneurysm Hemobilia Embolization

we report a case of a 74-year-old woman with a 16-year history of a double bilo-enteric anastomosis due to resected hilar cholangiocarcinoma [Type Ⅲb Klatskin tumor]. The patient presented with cholangitis secondary to benign anastomotic stenosis which resulted in a large intrahepatic biloma. In order to restore the patency of the anastomosis and overcome cholangitis, several attempts took place,including endobiliary stenting, balloon-assisted biloplasty and transhepatic billiary drainage. Anastomotic patencywas achieved, complicated, however, by persistent upper gastro-intestinal bleeding, presented as hemobilia. A biloma-induced pseudoaneurysm of the left hepatic artery was diagnosed. This had ruptured into the biliary tract,and presented the actual cause of the hemobilia. Selective embolism of the pseudoaneurysm resulted in control of the hemorrhage, and was successfully combined with transhepatic dilatation of the anastomosis and percutaneous drainage of the biloma. The patient was ultimately cured and seems to be in excellent condition, 5 mo after treatment.