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Cystic Artery Stump Pseudoaneurysm Following Laparoscopic Cholecystectomy: A Case Report
Dalal Sibria1, Mohamed Elawad1, Loai J A Aker1
1Radiology Department, Hamad Medical Corporation, Doha, QAT.
Insights
Cystic artery stump pseudoaneurysm (CASP), a rare complication after laparoscopic cholecystectomy (LC), can cause serious bleeding. This case highlights successful management via trans-arterial embolization (TAE).
Area of Science:
- Gastroenterology and Hepatobiliary Surgery
- Interventional Radiology
Background:
- Cystic artery stump pseudoaneurysm (CASP) is a rare but serious complication following hepatobiliary procedures, particularly laparoscopic cholecystectomy (LC).
- Iatrogenic factors are a significant cause of CASP, often presenting with haemobilia.
Observation:
- A 38-year-old patient presented with right upper abdominal pain after LC.
- Magnetic resonance cholangiopancreatography (MRCP) identified bile duct injury.
- The patient subsequently developed haemobilia secondary to CASP.
Findings:
- Successful management of CASP with haemobilia was achieved using trans-arterial embolization (TAE).
- CASP can manifest months to years after initial surgery, emphasizing the need for vigilance.
Implications:
- Clinicians and radiologists must maintain a high index of suspicion for CASP post-LC.
- Early recognition and prompt treatment of CASP are crucial for preventing life-threatening hemorrhage.
Abstract:
Cystic artery stump pseudoaneurysm (CASP) is a potentially life-threatening condition that can be related to multiple etiologies, especially the iatrogenic factor owing to the increased number of hepatobiliary procedures. Most patients present with haemobilia. Here we report a successfully managed case of CASP that initially complained of right upper abdominal pain. A 38-year-old patient developed bile duct injury after laparoscopic cholecystectomy (LC) which was identified by magnetic resonance cholangiopancreatography (MRCP). Later, she developed haemobilia due to CASP which was then treated by trans-arterial embolization (TAE). CASP is a rare complication of post-LC, yet potentially life-threatening, with possible delayed complications occurring months to years after the surgery. Clinicians and radiologists should be aware of this important entity and its variable manifestations to facilitate early treatment.
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