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Ǵм Yeungnam Univ J Med 2018;35(1):109-113

CASE REPORT

Coil embolization of ruptured intrahepatic pseudoaneurysm through percutaneous transhepatic biliary drainage

Jee Young An1, Jae Sin Lee1, Dong Ryul Kim1, Jae Young Jang1, Hwa Young Jung1, Jong Ho Park2, Sue Sin Jin2
1Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul;
2Department of Internal Medicine, Changwon Fatima Hospital, Changwon, Korea
Corresponding Author: Jong Ho Park, Department of Internal Medicine, Changwon Fatima hospital, 45, Changi-daero, Uichang-gu, Changwon 51394, Korea
Tel: +82-2-55-270-1000, Fax: +82-2-55-265-7766
E-mail: 4796pjhsms@naver.com

Received: August 17, 2017, Revised: October 18, 2017 Accepted: October 19, 2017

Abstract

A 75-year-old man with chronic cholangitis and a common bile duct stone that was not previously identified was admitted for right upper quadrant pain. Acute cholecystitis with cholangitis was suspected on abdominal computed tomography (CT); therefore, endoscopic retrograde cholangiopancreatography with endonasal biliary drainage was performed. On admission day 5, hemobilia with rupture of two intrahepatic artery pseudoaneurysms was observed on follow-up abdominal CT. Coil embolization of the pseudoaneurysms was conducted using percutaneous transhepatic biliary drainage. After several days, intrahepatic artery pseudoaneurysm rupture recurred and coil embolization through a percutaneous transhepatic biliary drainage tract was conducted after failure of embolization via the hepatic artery due to previous coiling. After the second coil embolization, a common bile duct stone was removed, and the patient presented no complications during 4 months of follow-up. We report a case of intrahepatic artery pseudoaneurysm rupture without prior history of intervention involving the hepatobiliary system that was successfully managed using coil embolization through percutaneous transhepatic biliary drainage.

Key Words: Keywords: Hepatic artery; Pseudoaneurysm; Hemobilia; Embolization

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