Ascending Cholangitis secondary to migrated embolization coil of gastroduodenal artery pseudo-aneurysm a case report.
BACKGROUND
Gastroduodenalartery (GDA) pseudo-aneurysms are very rare. Their clinical importance lies in the eventuality of rupture, causing bleeding and ultimately exsanguination.


METHODS
We report the case of a man, with prior history of biliary surgery, presenting with haemobilia secondary to a rupture of GDA pseudo-aneurysm eroding the main bile duct. The patient was treated with coil embolization. This technique is considered to be safe. However, on the long term, some complications may occur. In our case, the patient presented with cholangitis subsequent to coil migration in the lower bile duct. This situation was managed using endoscopic retrograde cholangiopancreatography (ERCP) allowing coil extraction with favorable evolution.


CONCLUSIONS
GDA pseudo-aneurysms are very rare. Bleeding, secondary to the rupture of these lesions, is a serious complication that could lead to death. Diagnosis and treatment of ruptured GDA pseudo-aneurysms rely on angiography. This method is considered to be safe. Cholangitis secondary to coil migration in the main bile duct is exceedingly rare,but remains an eventuality that physicians should be cognizant of.
Department of General Surgery Habib Thameur Hospital, Ali Ben Ayed Street's 2037 Montfleury, Tunis, Tunisia. zaafouri.haithem@hotmail.fr.
Haithem
H
Zaafouri
Department of General Surgery Habib Thameur Hospital, Ali Ben Ayed Street's 2037 Montfleury, Tunis, Tunisia.
Anis
A
Hasnaoui
Department of Radiology Habib Thameur Hospital, Tunis, Tunisia.
Sonia
S
Essghaeir
Department of General Surgery Habib Thameur Hospital, Ali Ben Ayed Street's 2037 Montfleury, Tunis, Tunisia.
Dhafer
D
Haddad
Department of Gastroenterology Habib Thameur Hospital, Tunis, Tunisia.
Meriam
M
Sabbah
Department of General Surgery Habib Thameur Hospital, Ali Ben Ayed Street's 2037 Montfleury, Tunis, Tunisia.
Ahmed
A
Bouhafa
Department of Gastroenterology Habib Thameur Hospital, Tunis, Tunisia.
Jamel
J
Kharrat
Department of General Surgery Habib Thameur Hospital, Ali Ben Ayed Street's 2037 Montfleury, Tunis, Tunisia.
Anis
A
Ben Maamer
D017541:Aneurysm, False / Q000150:complications / Q000628:therapy*; D017542:Aneurysm, Ruptured / Q000150:complications / Q000628:therapy*; D000792:Angiography; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002761:Cholangitis / Q000209:etiology* / Q000628:therapy; D003135:Common Bile Duct; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000295:instrumentation; D005548:Foreign-Body Migration / Q000150:complications*; D006431:Hemobilia / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D013270:Stomach / Q000098:blood supply*
Cholangitis; Embolization coil; Gastroduodenal artery; Haemobilia; Pseudo-aneurysm