Life-threatening hemobilia caused by hepatic pseudoaneurysm after T-tube choledochostomy: report of a case

Hemobilia is a rare but lethal biliary tract complication. There are several causes of hemobilia which might be classified as traumatic or nontraumatic. Hemobilia caused by pseudoaneurysm might result from hepatobiliary surgery or percutaneous interventional hepatobiliary procedures. However, to our...

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Bibliographic Details
Published in:BMC gastroenterology 2010-07, Vol.10 (1), p.81-81, Article 81
Main Authors: Lee, Yueh-Tsung, Lin, Ho, Chen, Kuan-Yung, Wu, Hurng-Sheng, Hwang, Min-Ho, Yan, Sheng-Lei
Format: Article
Language:English
Subjects:
Abdominal pain
Aged
Aneurysm, False - complications
Aneurysm, False - etiology
Aneurysms
Angiography
Care and treatment
Case Report
Case studies
Cholangitis - surgery
Cholecystectomy
Cholecystitis, Acute - surgery
Choledochostomy - adverse effects
Choledochostomy - methods
Complications and side effects
Diagnosis
Health aspects
Hemobilia - diagnosis
Hemobilia - etiology
Hepatic Artery
Humans
Jaundice
Male
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Summary:Hemobilia is a rare but lethal biliary tract complication. There are several causes of hemobilia which might be classified as traumatic or nontraumatic. Hemobilia caused by pseudoaneurysm might result from hepatobiliary surgery or percutaneous interventional hepatobiliary procedures. However, to our knowledge, there are no previous reports pertaining to hemobilia caused by hepatic pseudoaneurysm after T-tube choledochostomy. A 65-year-old male was admitted to our hospital because of acute calculous cholecystitis and cholangitis. He underwent cholecystectomy, choledocholithotomy via a right upper quadrant laparotomy and a temporary T-tube choledochostomy was created. However, on the 19th day after operation, he suffered from sudden onset of hematemesis and massive fresh blood drainage from the T-tube choledochostomy. Imaging studies confirmed the diagnosis of pseudoaneurysm associated hemobilia. The probable association of T-tube choledochostomy with pseudoaneurysm and hemobilia is also demonstrated. He underwent emergent selective microcoils emobolization to occlude the feeding artery of the pseudoaneurysm. Pseudoaneurysm associated hemobilia may occur after T-tube choledochostomy. This case also highlights the importance that hemobilia should be highly suspected in a patient presenting with jaundice, right upper quadrant abdominal pain and upper gastrointestinal bleeding after liver or biliary surgery.
ISSN:1471-230X
1471-230X
DOI:10.1186/1471-230X-10-81