1/14. Successful treatment of a pseudoaneurysm of the cystic artery with microcoil embolization.Pseudoaneurysms of visceral arteries are uncommon but well-characterized vascular abnormalities, usually provoked by intraabdominal inflammatory processes such as pancreatitis or cholecystitis, or by surgical trauma. However, pseudoaneurysms of the cystic artery are rare. They complicate cholecystitis or cholecystectomy, and manifest as hemobilia as they rupture into the biliary tree. The advent of transcatheter embolization techniques has begun to allow minimally invasive treatment of these life-threatening complications. Transcatheter embolization can be performed using several types of material, such as synthetic occlusive emulsions, gelatin sponges or other particles, or metallic microcoils. Microcoils are small metallic helical particles, made of stainless-steel, platinum, or tungsten. Super-selective catheterization of an artery and release of microcoils causes the vessel to thrombose and allows control of bleeding.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/14. Laparoscopic cholecystectomy and the Peter Pan syndrome.We report the case of a patient who experienced hemobilia a few weeks after undergoing laparoscopic cholecystectomy (LC). This condition was due to the rupture of a pseudo-aneurysm of the right hepatic artery in the common bile duct, probably caused by a clip erroneously fired during LC on the lateral right wall of the vessel. It also caused the formation of multiple liver abscesses and the onset of sepsis. This life-threatening complication led to melena, fever, epigastric pain, pancreatitis, liver dysfunction, and severe anemia, requiring urgent hospitalization and operation. In the operating theater, the fistula was closed, the liver abscesses drained, and a Kehr tube inserted. Thereafter, the patient's general condition improved, and she is now well. LC is often considered to be the gold standard for the management of symptomatic cholelithiasis. However, recent data have undermined that opinion. The apparent advantages offered by LC in the short term (less pain, speedier recovery, shorter hospital stay, and lower costs) have been overwhelmed by the complications that occur during long-term follow-up. When the late downward trend in the bile duct and the vascular injury rate are taken into consideration, the learning curve is prolonged. Therefore, LC should be regarded as the surgical equivalent of a modern Peter Pan-i.e., it is like a young adult who should make definitive steps toward becoming an adult but does not succeed in doing so. We report the case of a patient who experienced hemobilia a few weeks after undergoing laparoscopic cholecystectomy. Based on the facts in this case, we argue that the endoscopic procedure still needs to be perfected and cannot yet be considered the gold standard for selected cases of gallstone disease.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/14. Pancreaticobiliary arteriovenous malformation with common bile duct dilation in a patient with hemobilia.Arteriovenous malformation of the pancreas is a very rare entity. We describe a case involving the head of the pancreas associated with progressive hemobilia bleeding from the lower part of the common bile duct. The patient was a 50-year-old man with acute epigastralgia. Endoscopic retrograde cholangiopancreatography revealed hemobilia and cystic dilation of the common bile duct. angiography demonstrated increased blood volume in the head of the pancreas and early filling of the superior mesenteric and portal veins. abdominal pain and progressive anemia caused by hemobilia required surgical treatment. Histologic examination of the resected specimen revealed marked proliferation of the blood vessels in the pericholedochal area and the exact point of bleeding from the pancreaticobiliary arteriovenous malformation.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/14. hemobilia: four case reports and review of the literature.In this report, we present four cases of hemobilia. hemobilia occurs when conditions produce an abnormal communication between blood vessels and bile ducts. Although iatrogenic procedures as causes of hemobilia have been reported with increasing frequency, non-iatrogenic etiologies are still quite rare. We, therefore, report 4 cases of hemobilia secondary to different etiologies found in our institution from 1996 to 1998, that are non-iatrogenic. The first patient was a case of congenital aneurysm, the second pseudoaneurysm from trauma, the third cholangiocarcinoma and the fourth hepatocellular carcinoma. The classical triad consists of melena, jaundice and abdominal pain. Direct observation of blood flowing from the ampulla of vater by endoscopy was the initial diagnostic procedure in all four cases. diagnosis was confirmed by ultrasonography, computerized tomography, angiography or surgery. Transcatheter selective embolization as a noninvasive treatment for hepatic aneurysm/pseudoaneurysm is emphasized.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/14. hemobilia caused by liver abscess due to intrahepatic duct stones.hemobilia occurs when injury or disease causes communication between intrahepatic blood vessels and the biliary tract. Causes of hemobilia include trauma; gallstones; inflammatory diseases; and vascular disorders such as aneurysm, tumor, and coagulopathy. Recently, with the increasing use of invasive diagnostic and therapeutic procedures involving the hepatobiliary tract, an increasing proportion of the causes of hemobilia have been of iatrogenic origin. hemobilia may also be associated with liver abscess, but this condition is very rare. Our review of the English-language literature disclosed few cases of liver abscess associated with hemobilia. Here, we present a case of hemobilia caused by liver abscess due to intrahepatic duct stones. liver abscess should be considered in the causes of hemobilia, especially in areas where hepatobiliary parasitic infection is endemic.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/14. Non-operative management of endoscopic iatrogenic haemobilia: case report and review of literature.Haemobilia denotes an abnormal communication between a vessel of the splanchnic circulation and the biliary system. patients typically presents with the triad of abdominal pain, upper gastrointestinal haemorrhage, and jaundice. Common causes for haemobilia are iatrogenic causes secondary to hepatobiliary system instrumentation and trauma. Management of patients with haemodynamic significant haemobilia is aimed at stopping bleeding, maintaining continuous flow of biliary system, and cure of the underlying aetiology. Iatrogenic haemobilia after ERCP polyethylene biliary endoprosthesis placement is extremely uncommon. Herein we present a case of iatrogenic haemobilia triggered by biliary endoprosthesis placement and was successfully managed by non-operative treatment. The management algorithm for a rational approach to haemobilia is discussed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/14. Surgical management of traumatic hemobilia in children by direct ligation of the bleeding vessel.The surgical management of traumatic hemobilia by direct ligation of the bleeding vessel is described in two children. The operative procedures were performed with ease and without postoperative problems. Other available operative procedures are also discussed. Direct ligation of the bleeding vessel is recommended as the operative procedure of choice.- - - - - - - - - - ranking = 6keywords = vessel (Clic here for more details about this article) |
8/14. Report of a rare case of significant hemobilia and review of this entity.hemobilia, regardless of the etiology, is a serious manifestation of disease and/or injury. It is an abnormal communication of intra- or extra-hepatic bile ducts with blood vessels, and often not considered in the differential diagnosis of upper gastrointestinal hemorrhage. If appropriate treatment is delayed or omitted, the end result may be devastating. Malignant melanoma, a ubiquitous tumor, metastasizes to practically every body part. It is almost never responsible for significant hemobilia. An example of a patient with hemobilia caused by melanoma is reported and discussed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/14. Hematobilia from ruptured hepatic artery aneurysm. Report of two cases.Hematobilia secondary to hepatic artery aneurysm must be considered in the differential diagnosis of unexplained gastrointestinal tract hemorrhage. We treated two patients with ruptured hepatic artery aneurysm. One had hepatic artery aneurysm proximal to the gastroduodenal artery; the other had an intrahepatic pseudoaneurysm in the right lobe of the liver. The first patient was treated with obliterative endoaneurysmorrhaphy. The second required ligation of feeding vessels, cholecystectomy, and reconstruction of cholecystoduodenal fistula.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/14. hemobilia developing from an aneurysm of the left gastric artery.In the case reported herein, hemobilia was caused by an aneurysm of the left gastric artery which arose as a separate vessel from the aorta. The role of subselective angiography in the evaluation of hemobilia is emphasized.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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