Hemobilia due to arteriobiliary fistula complicating ERCP for residual bile duct stone in a case of Mirizzi syndrome

Mathur, Surendrakumar; Thapar, Vinaykumar B.; Chowda, Vasudev

doi:10.14701/ahbps.2017.21.2.88

Cited by 6 publications

(4 citation statements)

References 6 publications

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“…Definitive treatment was achieved with selective angiography, the gold standard to identify and stop the bleeding [10]. Transarterial embolization with coils is preferred over liquid embolic agents because coils cause less distal embolization thus less risk of liver infarction.…”

Section: Discussionmentioning

confidence: 99%

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Hemobilia after laparoscopic gallbladder bed resection and portal lymphadenectomy for incidental gallbladder adenocarcinoma

Gonçalves

Valente

Sousa

et al. 2022

J Case Rep Images Surg

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Introduction: Upper gastrointestinal bleeding caused by hemobilia is rare and a consequence of vascular-biliary fistula. These fistulas are mainly associated with biliary surgeries’ iatrogenic injuries. Case Report: This case reports of an elderly man with prior history of laparoscopic gallbladder bed resection and portal lymphadenectomy, which presented with hemobilia one month after the surgery. Diagnosis was not straightforward, but the patient was successfully treated with selective arteriography and hepatic artery stenting. Conclusion: High suspicion for hemobilia in a patient with right upper quadrant pain, jaundice, and blood loss in the stools after biliary surgery and rapid intervention are essential to avoid further complications.

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Section: Discussionmentioning

confidence: 99%

“…The classic symptoms of hemobilia are Quincke's triad: jaundice, right upper quadrant colicky pain, and GI bleeding. This triad is found in about 22-40% of the patients [4,9,10]. When blood clots obstruct the bile ducts, jaundice and pain worsens.…”

Section: Introductionmentioning

confidence: 99%

Hemobilia after laparoscopic gallbladder bed resection and portal lymphadenectomy for incidental gallbladder adenocarcinoma

Gonçalves

Valente

Sousa

et al. 2022

J Case Rep Images Surg

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“…The etiology of hemobilia may be related to the formation of an arterio-biliary fistula and subsequent rupture of the pseudoaneurysm into the bile duct [24]. Other causes of hemobilia include trauma, liver biopsy, retrograde cholangiopancreatography (ERCP), biliary stent placement, vasculitis, or hepatobiliary tumor [25][26][27][28].…”

Section: Discussionmentioning

confidence: 99%

Recurrent right hepatic artery pseudoaneurysm after robotic-assisted cholecystectomy in a patient with Mirizzi syndrome: a case report

Hsiung

Lee

et al. 2022

BMC Surg

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Background Iatrogenic hepatic artery pseudoaneurysm is a rare complication following laparoscopic cholecystectomy. Trans-arterial embolization (TAE) is an effective way to control bleeding after a ruptured aneurysm. But uncommonly, rebleeding may occur which will require a second embolization or even laparotomy. Case presentation We report a case of a 45-year-old woman who underwent robotic-assisted cholecystectomy after the diagnosis of type II Mirizzi syndrome. During the operation, the anterior branch of the right hepatic artery was damaged and Hem-o-lok clips were applied to control the bleeding. The postoperative course was smooth, and the patient was discharged 6 days after the procedure. However, one week after hospital discharge, she presented to the emergency department with right upper abdominal tenderness, melena, and jaundice. After examination, the computed tomography angiography (CTA) revealed a 3 cm pseudoaneurysm at the distal stump of the right hepatic artery anterior branch. TAE with gelfoam material was performed. Three days later, the patient had an acute onset of abdominal pain. A recurrent pseudoaneurysm was found at the same location. She underwent TAE again but this time with a steel coil. No further complication was noted, and she was discharged one week later. Conclusions Even with the assistance of modern technologies such as the robotic surgery system, one should still take extra caution while handling the vessels. Also, embolization of the pseudoaneurysm with steel coils may be suitable for preventing recurrence.

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“…At the moment, with the uprising of new technologies and a better understanding of the pathophysiology of biliary pathology, new causes of this rare problem have been described as well as its relationship with some percutaneous and endoscopic biliary procedures [ 2 ]. Some vascular anomalies facilitate the appearance of this type of biliary bleeding such as aneurysms or arterio-biliary fistulas [ 3 ]. Given their arterial origin, these hemorrhages can be life-threatening and may condition the need for immediate therapeutic action [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Endovascular and Endoscopic Treatment of Hemobilia: A Report of Two Cases

Cardona¹,

Rivero²,

Pinto³

et al. 2022

Cureus

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Hemobilia is a term used to describe bleeding caused by abnormal communication between blood vessels and bile ducts. Some vascular anomalies, such as aneurysms or arterio-biliary fistulas, facilitate the appearance of this type of biliary bleeding. Other causes have been described such as iatrogenic causes secondary to percutaneous procedures, infections, tumors, and trauma. We report two cases of hemobilia. The first one presented with acute biliary bleeding with secondary hypovolemic shock. Bleeding was controlled after percutaneous interventions with a selective embolization technique. The second case was a patient who presented to the emergency department after a fall from his height. During hospitalization, acute cholangitis was documented, associated with hemobilia. A wide papillotomy and biliary duct instrumentation were done with the extraction of a large blood clot. Angiography is the standard for diagnosis and embolization becomes the best tool for the detection and control of vascular abnormalities that can perpetuate bleeding.

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Hemobilia due to arteriobiliary fistula complicating ERCP for residual bile duct stone in a case of Mirizzi syndrome

Cited by 6 publications

References 6 publications

Hemobilia after laparoscopic gallbladder bed resection and portal lymphadenectomy for incidental gallbladder adenocarcinoma

Hemobilia after laparoscopic gallbladder bed resection and portal lymphadenectomy for incidental gallbladder adenocarcinoma

Recurrent right hepatic artery pseudoaneurysm after robotic-assisted cholecystectomy in a patient with Mirizzi syndrome: a case report

Endovascular and Endoscopic Treatment of Hemobilia: A Report of Two Cases

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