Hemobilia after bile duct resection: perforation of pseudoaneurysm into intra-pancreatic remnant bile duct: a case report

• Yoshida, Kazuhiro

• Umeda, Yuzo

• Iwamuro, Masaya

• Matsumoto, Kazuyuki

• Kato, Hironari

• Uka, Mayu

• Matsui, Yusuke

• Yoshida, Ryuichi

• Kuise, Takashi

• Yasui, Kazuya

• Takagi, Kosei

• Araki, Hiroyuki

• Yagi, Takahito

• Fujiwara, Toshiyoshi

抄録

Background</br> Hemobilia occurs mainly due to iatrogenic factors such as impairment of the right hepatic or cystic artery, and/or common bile duct in hepatobiliary-pancreatic surgery. However, little or no cases with hemobilia from the intra-pancreatic remnant bile duct after bile duct resection (BDR) has been reported. Here, we report a case of massive hemobilia due to the perforation of psuedoaneurysm of the gastroduodenal artery (GDA) to the intra-pancreatic remnant bile duct after hepatectomy with BDR.</br> Case presentation</br> A 68-year-old male underwent extended right hepatectomy with BDR for gallbladder carcinoma. He presented with upper gastrointestinal bleeding 2 months after the initial surgery. Upper endoscopy identified a blood clot from the ampulla of Vater and simultaneous endoscopic balloon tamponade contributed to temporary hemostasis. Abdominal CT and angiography revealed a perforation of the psuedoaneurysm of the GDA to the intra-pancreatic remnant bile duct resulting in massive hemobilia. Subsequent selective embolization of the pseudoaneurysm with micro-coils could achieve complete hemostasis. He survived without any recurrence of cancer and bleeding.</br> Conclusion</br> Hemobilia could occur in a patient with BDR due to perforation of the pseudoaneurysm derived from the GDA to the intra-pancreatic remnant bile duct. Endoscopic balloon tamponade was useful for a temporal hemostasis and a subsequent radiologic interventional approach.

収録刊行物

• BMC Surgery

  BMC Surgery 20 (1), 307-, 2020-12-01

  BMC

キーワード

• Hemobilia
• Bile duct resection
• Hepatectomy
• Endoscopic balloon tamponade
• Case report

詳細情報

• CRID: 1050850578859704576
• NII論文ID: 120006941057
• ISSN: 14712482
• DOI: 10.1186/s12893-020-00981-8
• Web Site: https://ousar.lib.okayama-u.ac.jp/61198
• Web Site: http://link.springer.com/content/pdf/10.1186/s12893-020-00981-8.pdf
• Web Site: http://link.springer.com/article/10.1186/s12893-020-00981-8/fulltext.html
• 本文言語コード: en
• 資料種別: journal article
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