Cystic artery pseudoaneurysm

Last revised by Mostafa Elfeky on 14 Jun 2023

Cystic artery pseudoaneurysms are rare and most commonly related to acute cholecystitis 1.

The most common clinical manifestations are 4,5,9:

  • right hypochondriac pain
  • epigastric pain
  • gastrointestinal bleeding
  • hemobilia

Rupture of a cystic artery pseudoaneurysm may cause a severe intraperitoneal bleed +/- hypovolemic shock.

The pathogenesis of cystic artery pseudoaneurysm is related to erosion of the wall of the cystic artery, secondary to gallbladder inflammation with adventitial weakening resulting in pseudoaneurysm formation 2.

Recommended management of a cystic artery pseudoaneurysm is urgent angioembolization followed by immediate cholecystectomy 3-7.

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