Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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Coil embolization of ruptured intrahepatic pseudoaneurysm through percutaneous transhepatic biliary drainage

  • An, Jee Young (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Lee, Jae Sin (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Kim, Dong Ryul (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Jang, Jae Young (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Jung, Hwa Young (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Park, Jong Ho (Department of Internal Medicine, Changwon Fatima Hospital) ;
  • Jin, Sue Sin (Department of Internal Medicine, Changwon Fatima Hospital)
  • Received : 2017.08.17
  • Accepted : 2017.10.19
  • Published : 2018.06.30
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Abstract

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.

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References

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  1. 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 Pro vol.55, pp.8, 2021, https://doi.org/10.1177/15385744211022591