2015 Volume 64 Issue 4 Pages 263-270
Cystic Artery Pseudoaneurysm of the Gallbladder（CAPG）is rare disease, and Japanese journals reported only 13 cases in the past. We report the case of a 59-year-old Japanese man, complicated CAPG with acute cholecystitis on January 2015. The patient was referred by his private doctor because of experienced melena, and he was diagnosed cholecystitis and anemia. An abdominal computed tomography（CT）scan clearly revealed a cystic mass about 3.0cm in diameter in the neck of gallbladder. We diagnosed that his melena was cause of bleeding from the gallbladder with CAPG. During the hospitalization, he received blood transfusions and antibiotics, while after 5days, his total bilirubin level was up to 3.4mg/dl. We suspected obstructive icterus resulting from hematoma in biliary tract, and inserted a pigtail catheter to biliary tract. Since then, his total bilirubin level returned rapidly to normal. On the 8th day from hospitalization, we operated cholecystectomy. Pathological examination revealed cholecystitis and fibrotic hematoma. We diagnosed CAPG derived from severe cholecystitis. Although CAPG is rare disease, it should be considered in cases with hematemesis and melena.
