2019 Volume 33 Issue 5 Pages 892-899
The patient was a 72 year-old male, who was transported to the ER complaining of fever and vomiting. He was admitted to our hospital with a diagnosis of acute cholecystitis with gallstone impaction. Although his symptoms improved after antibiotics therapy and PTGBD, hemorrhagic shock due to gallbladder bleeding occurred. Contrast CT revealed cystic artery pseudoaneurysm accompanying hemoperitoneum. Transcatheter arterial embolization (TAE) and subsequent laparoscopic cholecystectomy (LC) were performed. His postoperative course was uneventful and he was discharged at postoperative day 6. Cystic artery pseudoaneurysm is mostly recognized as gastrointestinal bleeding and rarely accompanies hemoperitoneum. Treatment should be decided according to the extent of hemorrhage, pseudoaneurysm, and cholecystitis. Preoperative TAE and subsequent LC is a feasible therapeutic option for ruptured cystic artery pseudoaneurysm especially for technically-difficult cases or cases with shock vital.
