総胆管内仮性動脈瘤による胆道出血に対する塞栓術の１例

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In this study, we report a case of hemobilia caused by a pseudoaneurysm in the common bile duct (CBD), which was treated using transcatheter arterial embolization. The patient was a woman in her 70s; she had CBD stones and had undergone endoscopic retrograde biliary drainage. The drainage tube had to be repeatedly changed because of obstruction. The patient developed anemia, and hemobilia occurred with progression of the anemia. On performing emergency arteriography, a saccular aneurysm was detected in the posterior superior pancreaticoduodenal artery (PSPDA); the aneurysm protruded into the CBD lumen and caused extravasation of the contrast medium into the bile duct. The patient was successfully treated using transcatheter arterial embolization therapy with metallic coils. Hemobilia caused by a pseudoaneurysm in the PSPDA is a rare condition. Our results indicate that transcatheter arterial embolization therapy with metallic coils is a useful treatment option for this condition.
一般社団法人日本インターベンショナルラジオロジー学会の論文