Acute hemobilia from a pseudoaneurysm of the cystic artery arising from the left hepatic artery: case report and literature review

• Published in: International journal of surgery case reports Vol. 37; pp. 60 - 64
• Main Authors: Trombatore, Claudia, Scilletta, Roberto, Bellavia, Noemi, Trombatore, Pietro, Magnano S. Lio, Vincenzo, Petrillo, Giuseppe, Di Cataldo, Antonio
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.01.2017; Elsevier
• Subjects: Anatomic variant splanchnic arteries; Case Report; Hemobilia; Interventional radiology; Pseudoaneurysm cystic artery; Surgery; pseudoaneurysm cystic artery; case report; interventional radiology; hemobilia; anatomic variant splanchnic arteries; Anatomic variant splanchnic arteries; Case report; Hemobilia; Interventional radiology; Pseudoaneurysm cystic artery
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2017.06.014

Highlights • In daily surgical practice hemobilia is very rare and can manifest as a clinic emergency. Its main aetiology is the iatrogenic injury of the biliary tree, recently increased for more frequent surgical, endoscopic or radiologic interventional procedures. Among non-iatrogenic causes the pseudoaneurysm of the cystic artery should be considered. • The cystic artery generally origins from the right hepatic artery and is located in the Calot’s triangle. Anatomic variations of the splanchnic arteries often involve hepatic arteries and more rarely the cystic artery. Surgeons and interventional radiologists should be familiar with these possible variants because they are fundamental in hepato-biliary procedures. • Because of the extreme rarity of the aneurism of the cystic artery, there are no guidelines about clinical management and treatment. Actually there is not a universal consensus if its endovascular embolization can be the definitive treatment or an intermediate step before cholecystectomy and ligation of the cystic artery. Others authors propose the only surgical approach.