Hepatic artery pseudo-aneurysm rupturing into hepato-gastric fistula, a rare cause of massive upper gastrointestinal hemorrhage: Case report

Hepatic artery pseudo-aneurysm and hepato-fastric fistula are extremely rare clinical entities, which can be caused as complications of amoebic liver abscess. Herein, we report a 45- year old man, who presented with history of hematemesis since last 1 day, melena since last 3 days and fever since la...

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Autores principales:	Arkadeep Dhali, MBBS, Avik Sarkar, MBBS, MD, Sukanta Ray, MBBS, MS, MCh, Dijendra Nath Biswas, MBBS, Gopal Krishna Dhali, MBBS, MD, DM, Ankit Mahajan, MBBS, MD
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2022
Materias:	Hepatic artery pseudo-aneurysm Hepato-gastric fistula Amoebic liver abscess Medical physics. Medical radiology. Nuclear medicine R895-920
Acceso en línea:	https://doaj.org/article/85789befe8ad4142b27b70502aa71209
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spelling	oai:doaj.org-article:85789befe8ad4142b27b70502aa712092021-11-30T04:15:13ZHepatic artery pseudo-aneurysm rupturing into hepato-gastric fistula, a rare cause of massive upper gastrointestinal hemorrhage: Case report1930-043310.1016/j.radcr.2021.10.022https://doaj.org/article/85789befe8ad4142b27b70502aa712092022-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S193004332100741Xhttps://doaj.org/toc/1930-0433Hepatic artery pseudo-aneurysm and hepato-fastric fistula are extremely rare clinical entities, which can be caused as complications of amoebic liver abscess. Herein, we report a 45- year old man, who presented with history of hematemesis since last 1 day, melena since last 3 days and fever since last 5 days. On physical examination, he was hemodynamically stable, pallor was noted. Abdominal examination revealed tenderness over the right-upper quadrant. Per-rectal examination showed evidences of melena. Esophagogastroduodenoscopy revealed stomach communicating anteriorly with the abscess cavity from the surrounding, possibly from liver. There was no evidence of fresh bleed during the procedure. The abscess was drained and sent for microbiological evaluation. Computed tomographic angiography revealed a well defined saccular outpouching arising from common hepatic artery with surrounding ill-defined hypodensity around segment V and IVb of liver. Patient underwent transfemoral endovascular coil embolization. Post embolisation, DSA showed complete occlusion of pseudo-aneurysm. He was discharged on oral metronidazole and was doing well on 8-month follow-up with no episodes of rebleed.Arkadeep Dhali, MBBSAvik Sarkar, MBBS, MDSukanta Ray, MBBS, MS, MChDijendra Nath Biswas, MBBSGopal Krishna Dhali, MBBS, MD, DMAnkit Mahajan, MBBS, MDElsevierarticleHepatic artery pseudo-aneurysmHepato-gastric fistulaAmoebic liver abscessMedical physics. Medical radiology. Nuclear medicineR895-920ENRadiology Case Reports, Vol 17, Iss 1, Pp 133-136 (2022)
institution	DOAJ
collection	DOAJ
language	EN
topic	Hepatic artery pseudo-aneurysm Hepato-gastric fistula Amoebic liver abscess Medical physics. Medical radiology. Nuclear medicine R895-920
spellingShingle	Hepatic artery pseudo-aneurysm Hepato-gastric fistula Amoebic liver abscess Medical physics. Medical radiology. Nuclear medicine R895-920 Arkadeep Dhali, MBBS Avik Sarkar, MBBS, MD Sukanta Ray, MBBS, MS, MCh Dijendra Nath Biswas, MBBS Gopal Krishna Dhali, MBBS, MD, DM Ankit Mahajan, MBBS, MD Hepatic artery pseudo-aneurysm rupturing into hepato-gastric fistula, a rare cause of massive upper gastrointestinal hemorrhage: Case report
description	Hepatic artery pseudo-aneurysm and hepato-fastric fistula are extremely rare clinical entities, which can be caused as complications of amoebic liver abscess. Herein, we report a 45- year old man, who presented with history of hematemesis since last 1 day, melena since last 3 days and fever since last 5 days. On physical examination, he was hemodynamically stable, pallor was noted. Abdominal examination revealed tenderness over the right-upper quadrant. Per-rectal examination showed evidences of melena. Esophagogastroduodenoscopy revealed stomach communicating anteriorly with the abscess cavity from the surrounding, possibly from liver. There was no evidence of fresh bleed during the procedure. The abscess was drained and sent for microbiological evaluation. Computed tomographic angiography revealed a well defined saccular outpouching arising from common hepatic artery with surrounding ill-defined hypodensity around segment V and IVb of liver. Patient underwent transfemoral endovascular coil embolization. Post embolisation, DSA showed complete occlusion of pseudo-aneurysm. He was discharged on oral metronidazole and was doing well on 8-month follow-up with no episodes of rebleed.
format	article
author	Arkadeep Dhali, MBBS Avik Sarkar, MBBS, MD Sukanta Ray, MBBS, MS, MCh Dijendra Nath Biswas, MBBS Gopal Krishna Dhali, MBBS, MD, DM Ankit Mahajan, MBBS, MD
author_facet	Arkadeep Dhali, MBBS Avik Sarkar, MBBS, MD Sukanta Ray, MBBS, MS, MCh Dijendra Nath Biswas, MBBS Gopal Krishna Dhali, MBBS, MD, DM Ankit Mahajan, MBBS, MD
author_sort	Arkadeep Dhali, MBBS
title	Hepatic artery pseudo-aneurysm rupturing into hepato-gastric fistula, a rare cause of massive upper gastrointestinal hemorrhage: Case report
title_short	Hepatic artery pseudo-aneurysm rupturing into hepato-gastric fistula, a rare cause of massive upper gastrointestinal hemorrhage: Case report
title_full	Hepatic artery pseudo-aneurysm rupturing into hepato-gastric fistula, a rare cause of massive upper gastrointestinal hemorrhage: Case report
title_fullStr	Hepatic artery pseudo-aneurysm rupturing into hepato-gastric fistula, a rare cause of massive upper gastrointestinal hemorrhage: Case report
title_full_unstemmed	Hepatic artery pseudo-aneurysm rupturing into hepato-gastric fistula, a rare cause of massive upper gastrointestinal hemorrhage: Case report
title_sort	hepatic artery pseudo-aneurysm rupturing into hepato-gastric fistula, a rare cause of massive upper gastrointestinal hemorrhage: case report
publisher	Elsevier
publishDate	2022
url	https://doaj.org/article/85789befe8ad4142b27b70502aa71209
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Hepatic artery pseudo-aneurysm rupturing into hepato-gastric fistula, a rare cause of massive upper gastrointestinal hemorrhage: Case report

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