Haemorrhagic cholecystitis treated with endovascular embolization.

Area of Science:

• Interventional Radiology
• Gastroenterology
• Surgical Complications

Background:

• Haemorrhagic cholecystitis is a rare but serious complication of acute cholecystitis.
• Traditional management involves emergency cholecystectomy, which may not be suitable for all patients.
• Endovascular techniques offer a less invasive approach to manage acute bleeding complications.

Observation:

• A 52-year-old woman with haemorrhagic cholecystitis underwent endovascular coil embolization of the cystic artery.
• The patient experienced subsequent complications including a gallbladder fossa hematoma and bile leak.
• Management involved endoscopic retrograde cholangiopancreatography (ERCP) with biliary stenting and percutaneous drainage of an abscess.

Findings:

• Endovascular coil embolization successfully controlled hemorrhage from the cystic artery.
• Multidisciplinary management was required to address post-embolization complications.
• The patient was stabilized for eventual elective cholecystectomy.

Implications:

• Endovascular embolization is a valuable tool for managing acute haemorrhagic cholecystitis, particularly in patients requiring medical optimization.
• This approach can avert immediate surgical intervention, reducing risks associated with emergency procedures.
• It highlights the importance of a multidisciplinary approach in managing complex hepatobiliary complications.