Right hepatic artery pseudoaneurysm after choledocoduodenostomy: a case report

Background: Pseudoaneurysm of right hepatic artery is a rare complication after bile duct injury (BDI) repair. An unidentified rupture pseudoanuerysm will lead to mismanagement this fatal complication. Massive haemorrhage can present and causes high mortalityCase Description: We report 60-year-old female who suffered jaundice massive upper gastrointestinal bleeding two weeks cholodocoduodenostomy bypass surgery in rural hospital. That procedure was done because BDI laparoscopic cholecystectomy. Embolisation carried out identifying an pseudoaneurysm stop bleeding. Bleeding transiently stopped, rebleeding occurred several later. Surgery performed repeated third embolization Kariadi Ruptured choledocoduodenostomy anastomosis found. resected sutured. Choledocoduodenostomy closed. Continuity biliary tract maintained by re-reconstruction choledoco-jejunostomy roux n Y. Upper symptom disappeared, bilirubin level returned normal at outpatient follow up operation.Conclusion: This patient had hemobilia ruptured pseudoaneurysm. Triad Quincke which consist quadrant pain, bleeding, occurs 30% with hemobilia. sign must be managed quickly accurately. Angiography main diagnostic procedure. Arterial embolisation first line intervention the preserved case where occurs. Good anatomical knowledge prevent