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Lower gastrointestinal bleeding due to hepatic artery pseudoaneurysm following laparoscopic cholecystectomy

机译:腹腔镜胆囊切除术后肝动脉假性动脉瘤引起的下消化道出血

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Pseudoaneurysm of hepatic artery is a rare but known complication of laparoscopic cholecystectomy (LC). Such pseudoaneurysms may bleed in biliary tree, upper gastrointestinal (GI) tract or peritoneal cavity leading to life-threatening internal haemorrhage. It is very rare for them to present as lower GI bleeding. We report an unusual case of Right hepatic artery pseudoaneurysm developed following LC, which ruptured into hepatic flexure of colon resulting in catastrophic lower GI bleeding. This was associated with partial celiac artery occlusion due to thrombosis. Due to failure of therapeutic embolisation, the patient was subjected to exploratory laparotomy to control haemorrhage. Postoperatively, patient recovered well and was discharged on postoperative day 10. A strong index of suspicion is necessary for early diagnosis of such condition and to limit resultant morbidity. Angioembolisation is the first-line treatment and surgery is indicated in selected cases.Keywords: Angioembolisation, hepatic artery, laparoscopic cholecystectomy, pseudoaneurysm
机译:肝动脉假性动脉瘤是一种罕见但已知的腹腔镜胆囊切除术(LC)并发症。这种假性动脉瘤可能在胆道,上消化道或腹膜腔出血,导致危及生命的内出血。他们很少出现胃肠道出血。我们报告了一个不寻常的病例,它在LC后发展为右肝动脉假性动脉瘤,破裂成结肠的肝弯曲,导致灾难性的下消化道出血。这与由于血栓形成的部分腹腔动脉闭塞有关。由于栓塞治疗失败,患者接受了探索性剖腹术以控制出血。术后患者康复良好,并在术后第10天出院。强烈怀疑这一点对于早期诊断此类疾病和限制发病率是必要的。血管栓塞是一线治疗,在某些情况下需要手术治疗。关键词:血管栓塞,肝动脉,腹腔镜胆囊切除术,假性动脉瘤

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