Life-threatening hemobilia caused by hepatic artery pseudoaneurysm: a rare complication of chronic cholangitis.
Hemobilia is one of the causes of obscure gastrointestinal haemorrhage. Most cases of hemobilia are of iatrogenic or traumatic origin. Hemobilia caused by a hepatic artery pseudoaneurysm due to ascending cholangitis is very rare and its mechanism is unclear. We report a 74-year-old woman with a history of surgery for choledocholithiasis 30 years ago, suffering from a protracted course of life-threatening gastrointestinal bleeding. A small intestines series and endoscopic retrograde cholangiopancreatography revealed a chronic cholangitis with marked contrast reflux into the biliary tree. Angiography confirmed the bleeding from a pseudoaneurysm of the middle hepatic artery. Coil embolization achieved successful hemostasis. We discussed the mechanism and reviewed the literature.
Liu
Tsu-Te
TT
Division of Gastroenterology, Department of Medicine, Veterans General Hospital, Taipei, Taiwan.
Hou
Ming-Chih
MC
Lin
Han-Chieh
HC
Chang
Full-Young
FY
Lee
Shou-Dong
SD
D000368:Aged; D017541:Aneurysm, False / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D002761:Cholangitis / Q000150:complications*; D004621:Embolization, Therapeutic; D005260:Female; D006431:Hemobilia / Q000209:etiology*; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D011859:Radiography; D016896:Treatment Outcome