Massive Upper Gastrointestinal Bleeding; A Rare Manifestation of Complications of Laparoscopic Cholecystectomy

Authors

Abstract

Background: Laparoscopic cholecystectomy is the standard treatment for gallbladder diseases. Hepatic artery
pseudoaneurysm is a rare complication of bile duct injury. Rupture is accompanied by abdominal pain,
intraperitoneal bleeding, jaundice, and gastrointestinal bleeding (GIB). In this study, we introduce a patient who
underwent laparoscopic cholecystectomy. During the laparoscopic operation the patient needed open surgery due
to bleeding; and a month later, the patient presented with massive upper gastrointestinal bleeding.
Case Report: The patient was a 43-year-old woman with a history of laparoscopic cholecystectomy one month
before. She presented with complaints of abdominal pain and hematemesis. Gastrointestinal endoscopy showed
duodenal bulb erosion, and computed tomography (CT) scan showed evidence in favor of hepatic artery
pseudoaneurysm. The patient underwent emergency laparotomy due to hemorrhagic shock. Hematoma and
pseudoaneurysm of the right hepatic artery from superior mesenteric artery were seen in the exploration. The
exploration of subhepatic hematoma, hepatic artery repair, and abdominal cavity drainage was done. A few days
after the operation, the patient was discharged in good general condition, stable vital sign, normal laboratory
tests, and PO tolerance. There was no complication in one month follow-up.
Conclusion: Vascular injuries are rare complications in patients undergoing cholecystectomy, and its
manifestation as UGIB is very rare. Due to its high morbidity and mortality, it should be evaluated and treated as
soon as possible.

Keywords

References

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Journal of Isfahan Medical School
Volume 39, Issue 654
November and December 2022
Pages 982-986

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History

  • Receive Date: 03 April 2022
  • Accept Date: 03 April 2022

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