A case of hepatic artery pseudoaneurysm-induced hemobilia caused by a plastic biliary stent

Abstract

A 63-year-old man was treated with endoscopic stone removal and plastic stenting for bile duct gallstones. Laparoscopic cholecystectomy was performed 5 days later. Five days after the cholecystectomy, he experienced onset of sudden epigastric pain. Abdominal contrast-enhanced computed tomography scan (CE-CT) showed an 8-mm diameter aneurysm of the right hepatic artery that had penetrated into the common hepatic bile duct. On the non-contrasted phase, we observed a high-density substance, suggestive of hemobilia. After the CE-CT, the patient suffered a cardiopulmonary arrest because of hemorrhagic shock. He was resuscitated, and we performed abdominal angiography and a transarterial coil embolization. The patient was discharged on the 96th day after the aneurysm rupture. A hepatic pseudoaneurysm was found near the distal end of the double-pigtail plastic stent, and we considered the stent to be the cause of the hepatic arterial pseudoaneurysm.