Jaundice and bleeding caused by cystic artery pseudoaneurysm after cholecystectomy: A case report

Cystic artery pseudoaneurysm (PSA) after laparoscopic cholecystectomy is a rare but potentially fatal complication that can lead to both jaundice and gastrointestinal bleeding.

A 42-year-old woman, who was previously asymptomatic and undergoing a routine health examination, presented with jaundice and gastrointestinal bleeding 5 months after her laparoscopic cholecystectomy.

Initial MRCP raised concerns for bile duct obstruction, prompting consideration of biliary trauma or tumor. However, contrast-enhanced CT and subsequent angiography revealed a 2.5 cm PSA at the previous cystic artery branch, compressing the bile duct.

The patient underwent transarterial embolization (TAE) using stainless steel coils to occlude the PSA and control bleeding. This minimally invasive procedure successfully addressed the vascular lesion.

Following TAE, the patient's jaundice resolved, liver function normalized, and gastrointestinal bleeding ceased. She recovered without complications and remained asymptomatic during a 1-year follow-up.

Early multimodal imaging is critical for identifying rare vascular complications, such as cystic artery PSA, following laparoscopic cholecystectomy, while prompt minimally invasive interventions are essential for preventing severe outcomes.