Cystic artery pseudoaneurysm due to carcinoma of the gallbladder

Abstract

A 52-year-old man, with known case of hypertension and stroke, presented to us with an upper gastrointestinal bleed and abdominal pain. Ultrasonography of the abdomen showed haematoma within the gallbladder (GB), and Doppler ultrasound was suggestive of an aneurysm arising from the cystic artery (CA). CT of the abdomen showed a well-enhancing thick-walled GB suggestive of malignancy. It also showed the presence of a double CA along with an aneurysm of one of the cystic arteries, haematoma within the GB and haemoperitoneum. Digital subtraction angiography confirmed the presence of double CA and CA pseudoaneurysm. The CA was selective catheterised and embolised with N-butyl cyanoacrylate glue. The patient underwent extended radical cholecystectomy later and was reported to have adenocarcinoma of the GB.