title: Detection and treatment of an aneurysma spurium of the arteria hepatica dextra after laparoscopic cholecystectomy.
abstract: BACKGROUND
  Massive upper gastrointestinal hemorrhage can be the dominant symptom of decompensated liver cirrhosis, varices and ulcerations in the upper gastrointestinal tract. Postoperative complications are known to lead to these bleedings. Commonly, emergency endoscopy will be performed. Here we report of a patient with extensive bleeding caused by an aneurysma spurium of the arteria hepatica dextra induced by a laparoscopic cholecystectomy. The condition was diagnosed by the Doppler ultrasound scan of the liver.
  
  
  METHODS
  Initially the source of the gastrointestinal bleeding was caused by an ulcus Dieulafoy in the jejunum which was stopped by clipping. Continous bleeding was observed and traced to a rare complication of a laparoscopic cholecystectomy due to a gallbladder empyema. After surgical intervention the patient developed an aneurysma spurium of the arteria hepatica dextra which was in communication with the small bowel. The successful treatment was performed by embolizing the aneurysma.
  
  
  CONCLUSIONS
  The reasons for gastrointestinal bleedings are manifold. This case presents a seldom cause of a gastrointestinal bleeding due to an aneurysma of the hepatic arteria. The successful embolization was performed to ultimately stop the bleeding.
authors.affiliation: Department of Internal Medicine II, Witten/Herdecke University, Faculty of Health - School of Medicine, Campus Cologne-Merheim, Ostmerheimerstrasse 200, Cologne D-51109, Germany. oliver.kirschberg@web.de
authors.forename: Oliver
authors.initials: O
authors.lastname: Kirschberg
authors.forename: Andreas
authors.initials: A
authors.lastname: Scheding
authors.forename: Thomas
authors.initials: T
authors.lastname: Saers
authors.forename: Bernd
authors.initials: B
authors.lastname: Krakamp
mesh_terms: D017541:Aneurysm, False / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D000792:Angiography; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D004621:Embolization, Therapeutic; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D006499:Hepatic Artery; D006801:Humans; D019106:Postoperative Hemorrhage / Q000209:etiology*; D018615:Ultrasonography, Doppler, Color