Post-laparoscopic cholecystectomy extra-hepatic arterial pseudoaneurysm: An uncommon complication

Laparoscopic cholecystectomy is widely practiced and is rarely associated with any major complication. The incidence of vascular complications related to laparoscopic cholecystectomy is reported to be 0.8%. An extra-hepatic arterial pseudoaneurysm can occur either due to electrocautery thermal injury or due to the surgical clip application. It may communicate and bleed within the biliary tree and present as haemobilia. The patient usually presents weeks later after the laparoscopic cholecystectomy, with the apparent clinical picture of abdominal pain, upper gastrointestinal bleeding, and jaundice. Contrast-enhanced CT scan can help in diagnosis but is not confirmatory. Angiography can be diagnostic as well as therapeutic i.e., angiographic embolization can be performed. If embolization fails, then open surgical exploration should be planned. Here, we present a case of post cholecystectomy hemobilia, who presented 3 weeks later after surgery with melena and mild abdominal pain. The case was diagnosed as extra-hepatic artery bleeding pseudoaneurysm and was successfully treated with angioembolization.