Journal of Gastroenterology

, Volume 31, Issue 5, pp 750–754 | Cite as

Pseudoaneurysm of the cystic artery associated with upper gastrointestinal bleeding

  • Morio Nakajima
  • Hiroshi Hoshino
  • Eiji Hayashi
  • Ken'ichi Nagano
  • Daisaku Nishimura
  • Naoyuki Katada
  • Hiroshi Sano
  • Katsushi Okamoto
  • Katsumoto Kato
Case Reports

Abstract

Pseudoaneurysm of the cystic artery is a cause of hemobilia, and is extremely rare, with only eight cases having been reported in the world literature. We report a case of pseudoaneurysm of the cystic artery in a 72-year-old Japanese man. The patient experienced epigastric pain and melena, and was found to have jaundice and liver dysfunction. Repeated gastroendoscopy did not reveal the cause of the alimentary tract bleeding; however, color-Doppler ultrasonography detected an aneurysm of the cystic artery in the gallbladder. Selective hepatic arteriography demonstrated that the posterior branch of the cystic artery was markedly dilated and that an aneurysm had formed in the midst of the artery. We diagnosed hemobilia due to the pseudoaneurysm of the cystic artery, and associated gastrointestinal bleeding. Cholecystectomy was performed immediately. Pathologically, the gallbladder showed acute calculous cholecystitis. This case emphasizes the importance of including hemobilia in the differential diagnosis whenever gastrointestinal bleeding is associated with signs of biliary disorder; color-Doppler imaging is a favorable modality for the diagnosis of pseudoaneurysm of the cystic artery.

Key words

pseudoaneurysm cystic artery color-Doppler hepatic arteriography 

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Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • Morio Nakajima
    • 1
  • Hiroshi Hoshino
    • 1
  • Eiji Hayashi
    • 2
  • Ken'ichi Nagano
    • 1
  • Daisaku Nishimura
    • 1
  • Naoyuki Katada
    • 1
  • Hiroshi Sano
    • 2
  • Katsushi Okamoto
    • 2
  • Katsumoto Kato
    • 1
  1. 1.Department of Internal MedicineKoseiren Kamo HospitalAichiJapan
  2. 2.Department of SurgeryKoseiren Kamo HospitalAichiJapan

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