Cystic artery pseudo aneurysm in a patient with xanthogranulomatous cholecystitis: a multi-disciplinary approach towards management

Authors

  • Surabhi Sreekumar Department of General Surgery, Apollo Main Hospital, Chennai, Tamil Nadu, India
  • K. J. Raghunath Department of General Surgery, Apollo Main Hospital, Chennai, Tamil Nadu, India
  • S. Vijayalakshmi Department of General Surgery, Apollo Main Hospital, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-2902.isj20231978

Keywords:

Pneumobilia, CAP, Quinke's triad, Xanthogranulomatous cholecystitis, Multi-disciplinary approach

Abstract

Cystic artery pseudo aneurysm is a rare clinical entity, mostly occurring as a complication of laparoscopic cholecystectomy or following calculus cholecystitis. Patient presents with acute symptoms including upper gastro intestinal bleeding symptoms, abdominal pain and jaundice, the triad of symptoms termed as Quincke's triad, when there is a ruptured cystic artery pseudoaneurysm (CAP). Unruptured cases are mostly diagnosed incidentally. Here we present a 58-year-old patient presented to the emergency department with severe abdominal pain, malena and jaundice. CECT of abdomen was done which showed CAP. The patient was immediately taken up for radiological intervention and coiling of the pseudo aneurysm, which was unsuccessful. A covered stent was placed across the pseudoaneurysm in the right hepatic artery. Patient underwent Laparoscopic cholecystectomy and had an uneventful recovery. Owing to the fact that CAPs are rare entities, a high index of suspicion is required for diagnosis of the condition and when diagnosed, the patient can be managed by radiological intervention followed by definitive surgery which can be either open or laparoscopic. 

References

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Published

2023-06-28

Issue

Section

Case Reports