A Case of Cystic Artery Pseudoaneurysm of the Gallbladder

A case of cystic artery pseudoaneurysm is reported. A 72-year-old woman consulted a private medical doctor for right hypochondral pain and vomiting. Biliary colic was suspected and she was sent to our hospital. Before admission, she had no melena or hematemesis. Her serum total bilirubin, transaminase, alkaline phosphatase, and γ GPT levels were slightly elevated. Abdominal US revealed a tumor-like lesion about 3 cm in diameter at the neck of the gallbladder. In its center, there was a cystic, pulsating area. Color Doppler US showed flow signals in the cystic area. An abdominal CT scan revealed a round mass at the gallbladder neck. The cystic area was markedly enhanced on early phase dynamic CT. High density contents in the gallbladder and dilated common bile duct were also demonstrated. An arteriogram of the proper hepatic artery revealed cystic artery pseudoaneurysm. On the 2nd day after admission, open cholecystectomy was performed and a T-tube was placed in the common bile duct. Histological examination of the resected specimen revealed a deep ulceration at the neck of the gallbladder with a ruptured cystic artery at the bottom. A round hematoma with a fibrous cavity filled with blood was situated on the ulceration.