BackgroundHemobilia is a rare but lethal biliary tract complication. There are several causes of hemobilia which might be classified as traumatic or nontraumatic. Hemobilia caused by pseudoaneurysm might result from hepatobiliary surgery or percutaneous interventional hepatobiliary procedures. However, to our knowledge, there are no previous reports pertaining to hemobilia caused by hepatic pseudoaneurysm after T-tube choledochostomy.Case presentationA 65-year-old male was admitted to our hospital because of acute calculous cholecystitis and cholangitis. He underwent cholecystectomy, choledocholithotomy via a right upper quadrant laparotomy and a temporary T-tube choledochostomy was created. However, on the 19th day after operation, he suffered from sudden onset of hematemesis and massive fresh blood drainage from the T-tube choledochostomy. Imaging studies confirmed the diagnosis of pseudoaneurysm associated hemobilia. The probable association of T-tube choledochostomy with pseudoaneurysm and hemobilia is also demonstrated. He underwent emergent selective microcoils emobolization to occlude the feeding artery of the pseudoaneurysm.ConclusionsPseudoaneurysm associated hemobilia may occur after T-tube choledochostomy. This case also highlights the importance that hemobilia should be highly suspected in a patient presenting with jaundice, right upper quadrant abdominal pain and upper gastrointestinal bleeding after liver or biliary surgery.
Magnetic Resonance (MR) uses many exam of medical image field. In this case report, we found an interesting case. We did not call it as patient because she did not present any symptoms, thus we call it as subject. Natural cerebral vascular deficiency was seldom to be reported due to subject does not present any obvious symptoms when subject is health or young. Hope that this case report would increase we know more about the congenital part cerebral vascular deficiency. A 36 y old female, who come to our hospital for advanced medical health examination. On the regular radiology exam, the MRI showed she has a congenital part cerebral vascular deficiency on December in 2013. In general, main cerebral artery deficiency would cause some impact on physiological, however, its seemly does not affect her in daily or intelligent working, or we still not know would it affect to human. This case report showed a young women persistent hypoglossal artery was missing. We should continuous follow the subject by regular medical health examination. For her, we can prevent further congenital caused injuries. It also added a rare case of Taiwanese in medical imaging academic field.
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