Pictures in Digestive Pathology
نویسندگان
چکیده
Pseudoaneurysm of the cystic artery is a very rare entity; only a few cases have been reported in the literature (1). We present the case of a 74-year-old male admitted for pain in the right lower quadrant of the abdomen. The emergency abdominal CT scan showed abnormal structural findings in the gallbladder, with hypodense area, cholelithiasis, and involvement of the fat around the gallbladder. The findings suggesting xanthogranulomatous cholecystitis were confirmed by needle aspiration cytology. His course was unsatisfactory and, on day 14, he had an episode of pain in the upper gastrointestinal tract and melaena. The suspicion of haemobilia was confirmed by endoscopy. In the lower part of the ampulla of the duodenum, we identified a leaky hole into a cylindrical cavity and observed branching compatible with the biliary tree (Fig. 2). Magnetic resonance imaging showed a 1.8 cm lesion compatible with a pseudoaneurysm of the cystic artery (Fig. 3). Given the severity of the bleeding, selective embolisation of the cystic artery was performed on an emergency basis, by selective catheterisation of the hepatic artery and supraselective catheterisation
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