Right Hepatic Artery Pseudoaneurysm Following Laparoscopic Cholecystectomy: A Rare Complication Treated With Coil Embolization

腹腔镜胆囊切除术后右肝动脉假性动脉瘤:一种罕见并发症,采用弹簧圈栓塞术治疗

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Abstract

Hepatic artery pseudoaneurysm (HAPA) is an uncommon but potentially life-threatening vascular complication following laparoscopic cholecystectomy, often presenting days to weeks postoperatively. We describe the case of a 34-year-old female patient who presented 45 days following surgery with recurring hematemesis, melena, abdominal pain, and jaundice. Ultrasonography with colour Doppler suggested a vascular lesion near the porta hepatis, and triple-phase CT angiography confirmed a right hepatic artery (RHA) pseudoaneurysm leading to intrahepatic biliary radical dilatation (IHBRD). The patient underwent successful coil embolization, leading to full recovery without complications. HAPA should be considered in post-cholecystectomy patients who exhibit upper gastrointestinal (GI) hemorrhage or hemobilia. Early imaging diagnosis using Doppler ultrasound and CT angiography is imperative for timely intervention. Coil embolization provides a minimally invasive, effective alternative to open surgical repair, reducing associated morbidity and mortality. This case underscores the importance of prompt recognition and endovascular management of vascular complications following biliary surgery to prevent fatal outcomes.

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