Hepatic artery pseudoaneurysms are a significant health concern, often incidentally discovered during computed tomography (CT) scans, as their exact incidence rate remains unknown. The most common symptoms of a pseudoaneurysm are hematemesis, abdominal pain, anemia and jaundice. A triad of right upper quadrant pain, jaundice and overt upper gastrointestinal bleeding is a classic presentation of the condition, which occurs in only a third of patients with hemobilia. Patients have a high risk of rupture, and an endovascular approach with coil embolization is recommended. A case of a 28-year-old woman with a post-traumatic hepatic pseudoaneurysm is presented in which she was initially misdiagnosed and treated for cholecystitis. After the development of jaundice, hematemesis and melena, a CT angiography confirmed diagnosis. Endovascular embolization was performed successfully, and the patient recovered without complications. This case highlights the importance of prompt diagnosis of hepatic pseudoaneurysms, as a delayed diagnosis can result in significant morbidity and mortality.
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http://dx.doi.org/10.1093/jscr/rjad410 | DOI Listing |
Ann Surg Oncol
January 2025
Department of HPB Surgery and Liver Transplantation, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris-Cité, Clichy, France.
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View Article and Find Full Text PDFForensic Sci Med Pathol
January 2025
Unit of Legal Medicine, Department of Medical and Surgical Sciences, University of Bologna, Via Irnerio 49, 40126, Bologna, Italy.
A 36-year-old woman diagnosed with complicated cholecystolithiasis underwent elective laparoscopic cholecystectomy (LC), then converted to open cholecystectomy because of a massive intraoperative bleeding. Hemostasis was performed with clipping and suturing the source of bleeding. In post-operative period, the patient suffered from persistent anemia associated with hemoperitoneum diagnosed through abdominal CT scanning, in absence of any sign of active bleeding.
View Article and Find Full Text PDFJ Hypertens
January 2025
Hypertension Clinic of the Internal Medicine Department, Unidade Local de Saúde de São João.
In renal vasculitis, luminal narrowing can reduce blood flow and activate the renin-angiotensin-aldosterone system, causing renovascular hypertension. We present the case of a 47-year-old man with previous intestinal tuberculosis and episodes of lumbar pain, tender erythematous nodules and arthralgias. He had grade 3 hypertension, unresponsive to treatment, with left ventricular concentric hypertrophy and chronic kidney disease.
View Article and Find Full Text PDFACG Case Rep J
January 2025
Department of Medicine, Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Liver transplant may be necessary to manage infectious complications from severe structural biliary disease. In this report, we describe a 71-year-old woman with history of coil-embolized hepatic artery pseudoaneurysm who subsequently developed biliary obstruction resulting from coil erosion into the common hepatic duct. Resultant complications included recurrent cholangitis, bacteremia, and numerous hepatic abscesses.
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