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dc.contributor.authorTaghavi, Seyed Mohammad Javad
dc.contributor.authorJaya Kumar, Mahendra
dc.contributor.authorDamodaran Prabha, Ramesh
dc.contributor.authorPuhalla, Harald
dc.contributor.authorSommerville, Craig
dc.date.accessioned2021-12-17T03:46:35Z
dc.date.available2021-12-17T03:46:35Z
dc.date.issued2021
dc.identifier.issn2356-7759
dc.identifier.doi10.1155/2021/4492206
dc.identifier.urihttp://hdl.handle.net/10072/411015
dc.description.abstractBackground: Cystic artery pseudoaneurysms are rare. Most commonly, they occur secondary to acute cholecystitis or after a cholecystectomy. Complications include haemobilia, biliary obstruction, and haemorrhage. Given the rarity and associated morbidity, a high index of suspicion is required. This article reviews the current literature on cystic artery pseudoaneurysms to investigate its aetiology, clinical presentation, and management options. Methods: A broad search of the Medline and PubMed databases was carried through. All peer reviewed literatures published in the English language between 1991 and 2020 with keywords "cystic" and "artery" and "pseudoaneurysm" in the title were selected for review. No further exclusion criteria; all studies yielded from the search were included in the results of this review. Additionally, we present a case of cystic artery pseudoaneurysm treated at our centre and included this in our analysis. Results: Sixty-seven case reports were found between 1991 and 2020. Aetiologies: Aetiology of cystic artery pseudoaneurysm was found to be cholecystitis in 41 instances (61.2%), cholecystectomy in 18 instances (26.8%), idiopathic in 6 instances (8.9%) cholelithiasis in 1 instance (1.5%), and pancreatitis in 1 instance (1.5%). Complications: Fifty-two cases were complicated by haemobilia (77.6%), 36 by anaemia (53.7%), 25 by biliary obstruction (37.3%), 13 by haemodynamic shock (19.4%), 9 by haemoperitoneum (13.4%), and 6 by contained rupture (8.9%). Most commonly, patients had two or more of these complications. Management: Forty-four patients were managed with endovascular embolisation (65.7%), 21 with endoscopic intervention (31.3%), 18 with open cholecystectomy (26.9%), 13 with laparoscopic cholecystectomy (19.4%), and 6 with pseudoaneurysm ligation (9%). Delayed presentation postcholecystectomy ranged from 8 days to 3 years. Conclusions: Cystic artery pseudoaneurysms are rare complications of a common operation. The most common clinical presentation is haemobilia, which can be difficult to diagnose clinically. A high index of suspicion and prompt investigation with targeted imaging and intervention is required. This is especially pertinent in gastrointestinal bleeding postlaparoscopic cholecystectomy as a missed diagnosis could cause significant morbidity.
dc.description.peerreviewedYes
dc.languageeng
dc.publisherHindawi Limited
dc.relation.ispartofpagefrom4492206
dc.relation.ispartofjournalSurgery Research and Practice
dc.relation.ispartofvolume2021
dc.subject.fieldofresearchBiomedical and clinical sciences
dc.subject.fieldofresearchcode32
dc.titleCystic Artery Pseudoaneurysm: Current Review of Aetiology, Presentation, and Management
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationTaghavi, SMJ; Jaya Kumar, M; Damodaran Prabha, R; Puhalla, H; Sommerville, C, Cystic Artery Pseudoaneurysm: Current Review of Aetiology, Presentation, and Management, Surgery Research and Practice, 2021, 2021, pp. 4492206
dcterms.dateAccepted2021-11-05
dcterms.licensehttp://creativecommons.org/licenses/by/4.0/
dc.date.updated2021-12-17T01:59:21Z
dc.description.versionVersion of Record (VoR)
gro.rights.copyright© 2021 Seyed Mohammad Javad Taghavi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
gro.hasfulltextFull Text
gro.griffith.authorPuhalla, Harald


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