Journal of Yeungnam Medical Science

Case Reports

Coil embolization of ruptured intrahepatic pseudoaneurysm through percutaneous transhepatic biliary drainage: Jee Young An, Jae Sin Lee, Dong Ryul Kim, Jae Young Jang, Hwa Young Jung, Jong Ho Park, Sue Sin Jin; Yeungnam Univ J Med. 2018;35(1):109-113. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.109

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A 75-year-old man with chronic cholangitis and a common bile duct stone that was not previously identified was admitted for right upper quadrant pain. Acute cholecystitis with cholangitis was suspected on abdominal computed tomography (CT); therefore, endoscopic retrograde cholangiopancreatography with endonasal biliary drainage was performed. On admission day 5, hemobilia with rupture of two intrahepatic artery pseudoaneurysms was observed on follow-up abdominal CT. Coil embolization of the pseudoaneurysms was conducted using percutaneous transhepatic biliary drainage. After several days, intrahepatic artery pseudoaneurysm rupture recurred and coil embolization through a percutaneous transhepatic biliary drainage tract was conducted after failure of embolization via the hepatic artery due to previous coiling. After the second coil embolization, a common bile duct stone was removed, and the patient presented no complications during 4 months of follow-up. We report a case of intrahepatic artery pseudoaneurysm rupture without prior history of intervention involving the hepatobiliary system that was successfully managed using coil embolization through percutaneous transhepatic biliary drainage.

Citations

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The efficacy and clinical outcomes of transarterial embolization in acute massive upper gastrointestinal bleeding: a single-center experience
Mehmet TAHTABASI, Mehmet KOLU
Marmara Medical Journal.2021; 34(2): 180. CrossRef
Percutaneous Trans-Hepatic Embolization of an Iatrogenic Extra-Hepatic Pseudoaneurysm of the Right Hepatic Artery in a Patient With Previous Occlusion of the Proper Hepatic Artery: An Endovascular Procedure to Avoid a Difficult Surgical Repair
Giuseppe S. Gallo, Roberto Miraglia, Luigi Maruzzelli, Francesca Crinò, Christine Cannataci, Salvatore Gruttadauria
Vascular and Endovascular Surgery.2021; 55(8): 878. CrossRef

Non-surgical treatment of hemorrhagic shock caused by rupture of iatrogenic pseudoaneurysm.: Soon Young Kim, Tae Jun Kim, Seong Kyun Na, Seung Ah Park, Dong Min Jung, Yong Kyun Kim, Sang Ho Jo; Yeungnam Univ J Med. 2014;31(1):17-20. Published online June 30, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.1.17

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Abstract PDF: Iatrogenic femoral artery pseudoaneurysm is a complication in patients undergoing catheterization. The risk increased when large-bore sheaths, concomitant anticoagulation therapy, and antiplatelet therapy are used during the intervention. Ultrasound-guided thrombin injection has become the treatment of choice. Rapid expansion, rupture, infection, and mass effect resulting in distal or cutaneous ischaemia or peripheral neuropathy, as well as failure of other treatment options are all indications for surgery. We report a 48-year-old man who developed hemorrhagic shock due to femoral pseudoaneurysm rupture after coronary angiography, and successfully treated by ultrasound-guided thrombin injection.

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