Li QM, Ye B, Yang SW, Zhao H. Left hepatic artery pseudoaneurysm complicating endoscopic retrograde cholangiopancreatography: A case report. World J Clin Cases 2023; 11(24): 5835-5839 [PMID: 37727720 DOI: 10.12998/wjcc.v11.i24.5835]
Corresponding Author of This Article
Shang-Wen Yang, MPhil, Doctor, Department of Gastroenterology, Lishui Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, No. 289 Kuocang Road, Liandu District, Lishui 323000, Zhejiang Province, China. strawberry198709@163.com
Research Domain of This Article
Medicine, General & Internal
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. Aug 26, 2023; 11(24): 5835-5839 Published online Aug 26, 2023. doi: 10.12998/wjcc.v11.i24.5835
Left hepatic artery pseudoaneurysm complicating endoscopic retrograde cholangiopancreatography: A case report
Qiao-Mei Li, Bin Ye, Shang-Wen Yang, Huan Zhao
Qiao-Mei Li, Bin Ye, Shang-Wen Yang, Department of Gastroenterology, Lishui Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, Zhejiang Province, China
Huan Zhao, Department of Pathology, Lishui Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, Zhejiang Province, China
Author contributions: Li QM reviewed the literature and contributed to manuscript drafting; Zhao H performed the contributed to data collection; Yang SW and Ye B were responsible for the revision of the manuscript for important intellectual content; All authors issued final approval for the version to be submitted.
Supported bythe Medical Health Science and Technology Project of Zhejiang Provincial Health Commission, No. 2020KY1082; and No. 2021KY1238.
Informed consent statement: Informed written consent was obtained from the patient for publication of this 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 CARE Checklist (2016), and the manuscript was prepared and revised according to 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: Shang-Wen Yang, MPhil, Doctor, Department of Gastroenterology, Lishui Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, No. 289 Kuocang Road, Liandu District, Lishui 323000, Zhejiang Province, China. strawberry198709@163.com
Received: June 26, 2023 Peer-review started: June 26, 2023 First decision: July 7, 2023 Revised: July 22, 2023 Accepted: August 1, 2023 Article in press: August 1, 2023 Published online: August 26, 2023 Processing time: 59 Days and 22 Hours
Abstract
BACKGROUND
Pseudoaneurysms of the hepatic artery or its branches have been reported following abdominal trauma, iatrogenic injury at the time of many operations such as percutaneous transhepatic biliary drainage and cholecystectomy. Hepatic artery pseudoaneurysms after endoscopic retrograde cholangiopancreatography (ERCP) are uncommon and potentially life threatening and should be identified and treated rapidly.
CASE SUMMARY
We report a case of intra-abdominal hemorrhage secondary to a left hepatic artery pseudoaneurysm resulting from guide wire injury at ERCP. The patient primary diagnosis was acute biliary pancreatitis with cholangitis, he underwent ERCP on the third day of admission. During ERCP, the left intrahepatic bile duct was cannulated three times. Over the sixth day, Contrast enhanced computed tomography scan demonstrated left hepatic lobe contusion and a pseudoaneurysm formation. The patient was successfully treated with the embolization of a small branch of left hepatic artery angiographically.
CONCLUSION
The common complications of ERCP are pancreatitis, bleeding and perforation. False aneurysms occur as a result of damage to the wall of an artery. As far as we know, it is rare complication has been reported following ERCP. We advise urgent referral for angiographic embolization in this situation to avoid aneurysm rupture.
Core Tip: Hepatic artery pseudoaneurysms after endoscopic retrograde cholangiopancreatography are uncommon and potentially life threatening and should be identified and treated rapidly. Angiographic embolization is the preferred choice for the treatment of pseudoaneurysms, because transarterial angigraphy can find the precise site of vascular injury, and give a treatment at the same time.
