EURORAD ESR

Case 13732

Cystic artery pseudoaneurysm presenting as haematemesis

Author(s)
Subbarao Chandana, Trupti Dabholkar

Mid Cheshire Hospitals NHS Foundation Trust,
United Kingdom
CW14QJ.
Email:subbarao_cv@yahoo.co.uk
 
Patient
male, 81 year(s)
 
 
  • Figure 1
    Colour Doppler image of gallbladder

    Vascular lesion with colour flow in gallbladder. Gallbladder is thick-walled and shows internal echoes.

     
    Area of Interest: Abdomen; Biliary Tract / Gallbladder; Gastrointestinal tract; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Diagnostic procedure; Special Focus: Aneurysms;
     
     
  • Figure 2
    Unenhanced CT abdomen

    Hyperdensity in gall bladder suggestive of haemobilia.

     
    Area of Interest: Arteries / Aorta; Biliary Tract / Gallbladder; Vascular; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Blood; Haemorrhage;
     
     
  • Figure 3
    CT angiogram - axial image in arterial phase

    Round, well-defined, intensely enhancing lesion in gall bladder with enhancement similar to the aorta, suggestive of pseudoaneurysm. Note pericholecystic inflammatory changes and air foci in GB (due to...

     
    Area of Interest: Arteries / Aorta; Biliary Tract / Gallbladder; Vascular; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Aneurysms; Fistula; Inflammation;
     
     
  • Figure 4
    Coronal MIP image - arterial phase

    Intensely enhancing lesion in gall bladder - the pseudoaneurysm is clearly seen arising from the cystic artery.

     
    Area of Interest: Arteries / Aorta; Biliary Tract / Gallbladder; Vascular; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Aneurysms;
     
     
  • Figure 5
    Coronal MIP image - venous phase

    Enhancing lesion in gall bladder parallels arterial enhancement in the delayed phase.

     
    Area of Interest: Arteries / Aorta; Biliary Tract / Gallbladder; Vascular; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Aneurysms;
     
     
  • Figure 6
    Coronal VR image

    Cystic artery pseudoaneurysm - Clearly demonstrated on VR adjacent to right hepatic artery.

     
    Area of Interest: Arteries / Aorta; Vascular; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Aneurysms;
     
     
Vascular lesion with colour flow in gallbladder. Gallbladder is thick-walled and shows internal echoes.
 
Hyperdensity in gall bladder suggestive of haemobilia.
 
Round, well-defined, intensely enhancing lesion in gall bladder with enhancement similar to the aorta, suggestive of pseudoaneurysm. Note pericholecystic inflammatory changes and air foci in GB (due to cholecystoduodenal fistula).
 
Intensely enhancing lesion in gall bladder - the pseudoaneurysm is clearly seen arising from the cystic artery.
 
Enhancing lesion in gall bladder parallels arterial enhancement in the delayed phase.
 
Cystic artery pseudoaneurysm - Clearly demonstrated on VR adjacent to right hepatic artery.
 
 
 
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