Cystic Artery Hemorrhage after Cholecystostomy Catheter Exchange Treated with Transcatheter Embolization

David M Sada1,2, Zeyad A Metwalli1,2

  • 1Diagnostic and Therapeutic Care Line, Michael E. DeBakey VA Medical Center, Houston, Texas.

Insights

Hemorrhage from a cystic artery pseudoaneurysm, a rare complication after cholecystostomy, can cause significant bleeding. Transcatheter embolization effectively treated this condition in a patient with perihepatic hematoma and hemobilia.

Area of Science:

  • Gastroenterology
  • Vascular Surgery
  • Interventional Radiology

Background:

  • Cystic artery pseudoaneurysms are uncommon but serious complications.
  • Their exact pathogenesis, often linked to cholecystitis, remains unclear.
  • Hemorrhage can lead to severe outcomes like perihepatic hematoma and hemobilia.

Purpose of the Study:

  • To present a case of cystic artery pseudoaneurysm hemorrhage after cholecystostomy.
  • To describe the management of this rare complication.
  • To highlight the efficacy of transcatheter embolization.

Main Methods:

  • A case report of a patient experiencing hemorrhage from a cystic artery pseudoaneurysm.
  • The pseudoaneurysm developed post-cholecystostomy catheter exchange.
  • Treatment involved transcatheter embolization with ethylene-vinyl alcohol copolymer.

Main Results:

  • Successful hemorrhage control was achieved via transcatheter embolization.
  • The patient's perihepatic hematoma and hemobilia resolved.
  • No immediate complications were reported post-embolization.

Conclusions:

  • Cystic artery pseudoaneurysm rupture is a potential complication of cholecystostomy.
  • Transcatheter embolization is a safe and effective treatment option.
  • Prompt diagnosis and intervention are crucial for favorable outcomes.

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