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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: Dhali, Arkadeep, Sarkar, Avik, Ray, Sukanta, Biswas, Dijendra Nath, Dhali, Gopal Krishna, Mahajan, Ankit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8601960/
https://www.ncbi.nlm.nih.gov/pubmed/34820036
http://dx.doi.org/10.1016/j.radcr.2021.10.022
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author Dhali, Arkadeep
Sarkar, Avik
Ray, Sukanta
Biswas, Dijendra Nath
Dhali, Gopal Krishna
Mahajan, Ankit
author_facet Dhali, Arkadeep
Sarkar, Avik
Ray, Sukanta
Biswas, Dijendra Nath
Dhali, Gopal Krishna
Mahajan, Ankit
author_sort Dhali, Arkadeep
collection PubMed
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.
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spelling pubmed-86019602021-11-23 Hepatic artery pseudo-aneurysm rupturing into hepato-gastric fistula, a rare cause of massive upper gastrointestinal hemorrhage: Case report Dhali, Arkadeep Sarkar, Avik Ray, Sukanta Biswas, Dijendra Nath Dhali, Gopal Krishna Mahajan, Ankit Radiol Case Rep 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 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. Elsevier 2021-11-10 /pmc/articles/PMC8601960/ /pubmed/34820036 http://dx.doi.org/10.1016/j.radcr.2021.10.022 Text en © 2021 The Authors. Published by Elsevier Inc. on behalf of University of Washington. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Dhali, Arkadeep
Sarkar, Avik
Ray, Sukanta
Biswas, Dijendra Nath
Dhali, Gopal Krishna
Mahajan, Ankit
Hepatic artery pseudo-aneurysm rupturing into hepato-gastric fistula, a rare cause of massive upper gastrointestinal hemorrhage: Case report
title 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_short 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
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8601960/
https://www.ncbi.nlm.nih.gov/pubmed/34820036
http://dx.doi.org/10.1016/j.radcr.2021.10.022
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