Abstract
Pseudoaneurysm of the cystic artery is rare; to our knowledge, fewer than 30 cases have been reported worldwide. We report the first case of an unruptured pseudoaneurysm of the cystic artery with concurrent acute calculous cholecystitis. We incidentally detected the aneurysm by contrast-enhanced computed tomography (CT) in the edematous, thickened wall of the gallbladder neck in a 71-year-old man, whereas in most of the reported cases the disease presented as hemobilia. Because of the high risk of aneurysm rupture in this location, we avoided such interventions as percutaneous cholecystostomy and laparoscopic cholecystectomy. The aneurysm was localized pathologically in the undisrupted gallbladder wall, and elective open cholecystectomy with ligation of the cystic artery was performed successfully. Our case highlights the usefulness of CT for both diagnosis and patient management. Open cholecystectomy with ligation of the cystic artery is demonstrated as a reasonable first line of treatment for this unusual condition.
Similar content being viewed by others
References
Maeda A, Kunou T, Saeki S, Aono K, Murata T, Ninomi N, et al. Pseudoaneurysm of the cystic artery with hemobilia treated by arterial embolization and elective cholecystectomy. J Hepatobiliary Pancreat Surg 2002;9:755–758.
Wu TC, Liu TJ, Ho YJ. Pseudoaneurysm of the cystic artery with upper gastrointestinal hemorrhage: case report. Acta Chir Scand 1988;154:151–152.
Lee JW, Kim MY, Kim YJ, Suh CH. CT of acute lower GI bleeding in chronic cholecystitis: concomitant pseudoaneurysm of cystic artery and cholecystocolonic fistula. Clin Radiol 2006;61:634–636.
Rhee JW, Bonnheim DC, Upson J. Cystic artery pseudoaneurysm. N Y State J Med 1987;87:47.
Maw A, Mander BJ, Nandi SC, Taube M, Evans HJ. Pseudoaneurysm of the cystic artery. Eur J Surg 1997;163:307–309.
Delgadillo X, Berney T, de Perrot M, Didier D, Morel P. Successful treatment of a pseudoaneurysm of the cystic artery with microcoil embolization. J Vasc Interv Radiol 1999;10:789–792.
Strickland SK, Khoury MB, Kiproff PM, Raves JJ. Cystic artery pseudoaneurysm: a rare cause of hemobilia. Cardiovasc Intervent Radiol 1991;14:183–184.
Kaman L, Kumar S, Behera A, Katariya RN. Pseudoaneurysm of the cystic artery: a rare cause of hemobilia. Am J Gastroenterol 1998;93:1535–1537.
Nakajima M, Hoshino H, Hayashi E, Nagano K, Nishimura D, Katada N, et al. Pseudoaneurysm of the cystic artery associated with upper gastrointestinal bleeding. J Gastroenterol 1996;31:750–754.
Sibulesky L, Ridlen M, Pricolo VE. Hemobilia due to cystic artery pseudoaneurysm. Am J Surg 2006;191:797–798.
England RE, Marsh PJ, Ashleigh R, Martin DF. Case report: pseudoaneurysm of the cystic artery: a rare cause of haemobilia. Clin Radiol 1998;53:72–75.
Clements WD, Wilson RH, Crothers JG, McIlrath EM, Johnston GW. Pseudoaneurysm of the cystic artery following cholecystectomy. J R Coll Surg Edinb 1993;38:348–349.
Miura K, Hoshino T, Komatsu M, Ono T, Sato T, Tanaka J, et al. A case of hemorrhage into the gallbladder probably due to rupture of pseudoaneurysm formed by cystic artery. Nippon Shokakibyo Gakkai Zasshi 1998;95:450–454.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Machida, H., Ueno, E., Shiozawa, S. et al. Unruptured pseudoaneurysm of the cystic artery with acute calculous cholecystitis incidentally detected by computed tomography. Radiat Med 26, 384–387 (2008). https://doi.org/10.1007/s11604-008-0243-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11604-008-0243-x