Biliary tract compression caused by a giant abdominal aneurysm

摘要

A 90-year-old woman with a 12-year history of an abdominalaortic aneurysm (AAA) presented with nausea, appetiteloss, and a fever lasting three days. The patient declinedsurgery or invasive procedures for the AAA. On examination,there was jaundice and a pulsatile mass (8 cm)over the mid-abdomen. Laboratory data showed elevated serumbilirubin and biliary enzyme levels. An enhanced CTscan revealed an AAA of 15-cm in diameter with a thrombus(Picture 1) causing extrahepatic bile duct compressionassociated with proximal bile duct dilatation (Picture 2).