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A rare case of ruptured pseudoaneurysm of the cystic artery diagnosed by ultrasonography and followed by a successful urgent laparoscopic cholecystectomy Yusuke FUJII 1 , Noriyuki HIRAHARA 1 , Shunsuke KAJI 1 , Takeshi MATSUBARA 1 , Akihiko KIDANI 1 , Yoshitsugu TAJIMA 1 1Department of Digestive and General Surgery, Shimane University Faculty of Medicine Keyword: 胆囊仮性動脈瘤 , 胆囊出血 , 腹腔鏡下胆囊摘出 pp.71-75
Published Date 2016/1/15
DOI https://doi.org/10.11477/mf.4426200217
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An 87-year-old woman was referred to our hospital for the management of hemorrhagic shock related to hemobilia. Physical examination demonstrated a slight tenderness in the right hypochondrium. Abdominal ultrasonography showed a distended gallbladder filled with echogenic debris. In addition, color Doppler ultrasound depicted pulsatile blood-flow signals in the gallbladder at the bed of the gallbladder, suggesting the diagnosis of ruptured pseudoaneurysm of the cystic artery. After a blood transfusion, the patient underwent an urgent laparoscopic cholecystectomy. The operation went smoothly as planned. Macroscopically, an aneurysm-like structure, 4mm in size, was identified in the mucosa of the bed of the gallbladder. Any stones or tumors were not observed. The diagnosis of chronic cholecystitis was made histologically. The postoperative course was uneventful and the patient left our hospital on postoperative day 19. An abdominal Doppler ultrasound may allow us to detect a ruptured pseudoaneurysm of the cystic artery and urgent laparoscopic cholecystectomy could be the treatment of choice for such an acute abdomen requiring immediate surgery.


Copyright © 2016, JAPAN SOCIETY FOR ENDOSCOPIC SURGERY All rights reserved.

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電子版ISSN 2186-6643 印刷版ISSN 1344-6703 日本内視鏡外科学会

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