PSEUDOANEURYSM OF THE CYSTIC ARTERY - A RARE CAUSE OF HEMOBILIA

Aneurysms are a rare cause of hemobilia, and usually involved are bran ches of the hepatic and gastro-duodenal arteries. A case of a patient with hemobilia secondary to a pseudoaneurysm of the cystic artery is p resented. Fewer than 10 cases have been reported in the literature, an d in all of them the condition was associated with inflammation of the gall bladder, as in our case. Selective hepatic angiography is the pr ocedure of choice for diagnosis. Upper gastrointestinal endoscopy with side-viewing scopy can demonstrate bleeding from papilla. Color-Doppl er ultrasonography also may prove to be useful in equivocal cases. Cho lecystectomy and ligation of cystic artery with proximal control of th e hepatic artery was done at laparotomy after diagnosis was made. (Am J Gastroenterol 1998;93:1535-1537. (C) 1998 by Am. Cell. of Gastroente rology).