Hematobilia due to a pseudoaneurysm complicating a choledochal cyst

Eliscu, EH; Weiss, G. Derek

doi:10.2214/ajr.151.4.783

Cited by 14 publications

(4 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One report reviewed hemobilia from a ruptured pseudoaneurysm due to inflammation in a 21-month-old girl. Hemostasis was obtained with TAE, and division surgery was performed [ 21 ]. The other report reviewed hemobilia from benign biliary papillomatosis in a 57-year-old woman.…”

Section: Discussionmentioning

confidence: 99%

A case with massive hemobilia long-term after internal drainage surgery for congenital biliary dilation

et al. 2021

View full text Add to dashboard Cite

Background Currently, there is an unwavering consensus that the standard surgery for congenital biliary dilation (CBD) is extrahepatic bile duct resection and choledochojejunostomy. However, decades prior, choledochocyst–gastrointestinal anastomosis without extrahepatic bile duct resection (internal drainage surgery, IDS) was preferred for CBD because of its simplicity. Currently, there is almost no chance of a surgeon encountering a patient who has undergone old-fashioned IDS, which has been completely obsolete due to the risk of carcinogenesis from the remaining bile duct. Moreover, the pathological condition long after IDS is unclear. Herein, we report a case of life-threatening bile duct bleeding as well as carcinoma of the bile duct 62 years after IDS in a patient with CBD. Case presentation An 82-year-old Japanese woman with hemorrhagic shock due to gastrointestinal bleeding was transferred to our hospital. She had a medical history of unspecified surgery for CBD at the age of 20. Based on imaging findings and an understanding of the historical transition of the surgical procedure for CBD, the cause of gastrointestinal bleeding was determined to be rupture of the pseudoaneurysm of the dilated bile duct that remained after IDS. Hemostasis was successfully performed by transcatheter arterial embolization (TAE) in an emergency setting. Then, elective surgery for extrahepatic bile duct resection and choledochojejunostomy was performed to prevent rebleeding. Pathological examination revealed severely and chronically inflamed mucosa of the bile duct. Additionally, cholangiocarcinoma (Tis, N0, M0, pStage 0) was incidentally revealed. Conclusion It has been indicated that not only carcinogenesis, but also a risk of life-threatening bleeding exists due to long-lasting chronic inflammation to the remnant bile duct after IDS for CBD. Additionally, both knowledge of which CBD operation was performed, and an accurate clinical history are important for the diagnosis of hemobilia.

show abstract

Section: Discussionmentioning

confidence: 99%

A case with massive hemobilia long-term after internal drainage surgery for congenital biliary dilation

et al. 2021

View full text Add to dashboard Cite

show abstract

“…14 While papillomatosis has been separately reported associated with a choledochal cyst and haemobilia, 6,14 clinical presentation with haemobilia in a patient with a choledochal cyst due to papillomatosis has not been reported.…”

Section: Discussionmentioning

confidence: 99%

Benign biliary papillomatosis in a patient with a choledochal cyst presenting as haemobilia: a case report

Sen

Raju

Vyas

et al. 2012

annals

View full text Add to dashboard Cite

Biliary papillomatosis is a rare condition usually detected on imaging or postoperative histopathology. It may be asymptomatic or present with features of cholangitis. We report the management of a patient presenting with haemobilia.We report a rare case of benign biliary papillomatosis (BP) in a choledochal cyst. Papillomatosis arising from the intrahepatic portion of a choledochal cyst presenting with haemobilia has not been reported before. Case historyA 57-year-old woman presented initially with periumbilical pain that had lasted for a week. She also complained of tiredness but did not have loss of weight or appetite. Imaging in another hospital had revealed common bile duct thickening with intrahepatic biliary radicle dilatation and biliary sludge. She was suspected of having cholangiocarcinoma and underwent endoscopic retrograde cholangiopancreaticography (ERCP) with stent placement.General and systemic examination and blood tests were non-contributory. Magnetic resonance cholangiopancreaticography with computed tomography of the abdomen (MRCT) showed dilatation of the common bile duct and left hepatic duct (LHD). There were multiple hyperdense lesions in the LHD suggestive of intrahepatic stones (Figs 1 and 2).The patient was offered cholecystectomy, cholangioscopy, extraction of the hepatolithiasis and hepaticojejunostomy. She came back for the operation four months later. She was pale with a history of two episodes of melaena. Her haemoglobin was 5.7g% and her blood picture was consistent with iron deficiency anaemia. The coagulation profile was normal. Oesophagogastroduodenoscopy, colonoscopy and review of MRCT of the abdomen did not reveal the source of bleeding. She was diagnosed with obscure gastrointestinal bleeding and on-table enteroscopy was added to the plan of operation.

show abstract

“…Postoperatively, it has been reported as early as the first week to as late as 2 years [5]. Hepatic artery pseudoaneurysm in patients with choledochal cyst causing hemobilia has also been described in the literature [8,9].…”

Section: Discussionmentioning

confidence: 99%

Life-threatening postoperative hemorrhage from hepatic artery pseudoaneurysm successfully treated by transcatheter embolization in a 5-year-old

Kamath

Gunabushanam

Hanna

et al. 2012

Journal of Pediatric Surgery

View full text Add to dashboard Cite

Hematobilia due to a pseudoaneurysm complicating a choledochal cyst

Cited by 14 publications

References 4 publications

A case with massive hemobilia long-term after internal drainage surgery for congenital biliary dilation

A case with massive hemobilia long-term after internal drainage surgery for congenital biliary dilation

Benign biliary papillomatosis in a patient with a choledochal cyst presenting as haemobilia: a case report

Life-threatening postoperative hemorrhage from hepatic artery pseudoaneurysm successfully treated by transcatheter embolization in a 5-year-old

Contact Info

Product

Resources

About