Unruptured Pseudoaneurysm of Cystic Artery: A Case Report

Abstract

Cystic Artery Pseudoaneurysm (CAP) is a rare, abnormal dilation of the artery supplying the gallbladder. The main causes could be acute cholecystitis and iatrogenic injury during cholecystectomy. Ruptured pseudoaneurysm of cystic artery generally presents with haemobilia, and upper gastrointestinal bleeding or intraperitoneal bleeding. Only a few cases of unruptured CAP are reported that are successfully treated with open or laparoscopic cholecystectomy. This case is one of the rare cases of unruptured CAP where a 78-year-old female patient who was a known case of hypothyroidism, presented with upper abdominal pain and vomiting, diagnosed with acute calculous cholecystitis with CAP. She was managed with laparoscopic cholecystectomy, converted to open cholecystectomy and discharged with uneventful postoperative period. Due to the high risk of rupture, the patient required urgent surgical intervention either by open or laparoscopic cholecystectomy by a skilled laparoscopic surgeon. The operating need for conversion to laparotomy should be considered neither a failure nor a complication but an attempt to avoid intra and postoperative complications.