Pseudoaneurysm of the hepatic artery presenting with hemobilia--a complication of laparoscopic cholecystectomy

Background: Hemobilia, defined as a bleeding into the bile duct, is a rare disease. One of its infrequent causes is a hepatic artery pseudoaneurysm, usually developed after arterial iatrogenic leasion.

Methods: A case review, presenting right hepatic artery pseudoaneurysm with a biliovascular fistula as a consequence of hepatic artery and bile duct injuries during "uncomplicated" laparoscopic cholecystectomy.

Conclusions: Bile duct injury is one of the most serious complication after laparoscopic cholecystectomy. Hepatic artery may be injured simultaneously, resulting in the pseudoaneurysm and/or biliovascular fistula, presenting with hemobilia. Time interval from the injury to symptoms widely varies from few hours to weeks or even several months. Conclusions: Melena or hematemesis after recent laparoscopic cholecystectomy should be always suspicious from hepatic artery and/or bile duct injuries, manifesting with hemobilia.