Liu YL, Hsieh CT, Yeh YJ, Liu H. Cystic artery pseudoaneurysm: A case report. World J Clin Cases 2023; 11(1): 242-248 [PMID: 36687196 DOI: 10.12998/wjcc.v11.i1.242]
Corresponding Author of This Article
Hsien Liu, MD, PhD, Director, Division of General Surgery, Department of Surgery, Ditmanson Medical Foundation, Chia-yi Christian Hospital, No. 539 Zhongxiao Road, East District, Chiayi 600, Taiwan. hsienliucmh@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jan 6, 2023; 11(1): 242-248 Published online Jan 6, 2023. doi: 10.12998/wjcc.v11.i1.242
Cystic artery pseudoaneurysm: A case report
Yu-Ling Liu, Cheng-Ta Hsieh, Yao-Jen Yeh, Hsien Liu
Yu-Ling Liu, Division of General Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
Cheng-Ta Hsieh, Division of Neurosurgery, Department of Surgery, Sijhih Cathay General Hospital, New Taipei 22174, Taiwan
Cheng-Ta Hsieh, School of Medicine, National Tsing Hua University, Hsinchu 300044, Taiwan
Cheng-Ta Hsieh, Department of Medicine, School of Medicine, Fu Jen Catholic University, New Taipei 24205, Taiwan
Yao-Jen Yeh, Operating Room Technician, Ditmanson Medical Foundation, Chia-yi Christian Hospital, Chia-yi 600, Taiwan
Hsien Liu, Division of General Surgery, Department of Surgery, Ditmanson Medical Foundation, Chia-yi Christian Hospital, Chiayi 600, Taiwan
Author contributions: Liu YL drafted the manuscript; Yeh YJ and Liu H performed the endovascular intervention; Liu H collected the clinical data and performed the follow-up; Liu YL and Hsieh CT conducted the literature review; Hsieh CT and Liu H revised the manuscript critically for intellectual content; and all authors have read and approved the final manuscript.
Informed consent statement: With the approval of the Institutional Review Board of Chi Mei Hospital in Taiwan (Applicant’s number: 11007-E03), informed consent was obtained from the patient before the publication of this case report.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hsien Liu, MD, PhD, Director, Division of General Surgery, Department of Surgery, Ditmanson Medical Foundation, Chia-yi Christian Hospital, No. 539 Zhongxiao Road, East District, Chiayi 600, Taiwan. hsienliucmh@gmail.com
Received: October 27, 2022 Peer-review started: October 27, 2022 First decision: November 11, 2022 Revised: November 23, 2022 Accepted: December 15, 2022 Article in press: December 15, 2022 Published online: January 6, 2023 Processing time: 67 Days and 23.3 Hours
Abstract
BACKGROUND
Cystic artery pseudoaneurysm is a condition rarely encountered by clinicians; this, its etiology and presentation as well as appropriate treatments are not well studied. Although it is treated by removal of the diseased gallbladder and cystic artery, such surgery can be difficult and risky if acute inflammation with bleeding occurs, and not every patient can tolerate the surgery.
CASE SUMMARY
An 81-year-old man complained of epigastric pain and tarry stool passage that lasted for 3 d. He had a medical history of poor cardiopulmonary function. The computed tomographic scan of abdomen showed cystic artery pseudoaneurysm and dilatation of gallbladder. Because of high adverse outcomes related to general anesthesia, the patient was successfully managed with endovascular embolization for this cystic artery pseudoaneurysm and percutaneous drainage for the distended gallbladder.
CONCLUSION
A patient with cystic artery pseudoaneurysm may quickly deteriorate with the occurrence of concurrent arterial bleeding and sepsis. This report presents the case of a patient who did not undergo surgery due to multiple cardiopulmonary comorbidities and whose condition was managed successfully with embolization and biliary drainage. Endovascular embolization and biliary drainage may provide an alternative option to manage this complicated condition.
Core Tip: Cystic artery pseudoaneurysm is a condition rarely encountered by clinicians. A patient’s condition may quickly deteriorate with the occurrence of concurrent arterial bleeding and sepsis. Although it is treated by removal of the diseased gallbladder and cystic artery, such surgery can be difficult and risky if acute inflammation with bleeding occurs, and not every patient can tolerate the surgery. Endovascular embolization and biliary drainage may provide an alternative option to manage this complicated condition.
