Year 2025 / Volume 117 / Number 10
Digestive Diseases Image
Unexpected cause of upper gastrointestinal bleeding: beyond the typical complications of gallstone disease

584-585

DOI: 10.17235/reed.2024.10134/2023

Mara Sarmento Costa, Marta Gravito-Soares, Elisa Gravito-Soares, Pedro Figueiredo,

Abstract
An 88-year-old man presented with haematemesis with haemodynamic stability requiring transfusion of 5 units of blood. Physical examination was unremarkable. Upper endoscopy identified a fistulous opening in the proximal second part of the duodenum (D2) with an oozing bleed and blood clots. A computed tomography (CT)-angiogram revealed a 18mm cystic artery pseudoaneurysm next to a fistulous communication between the gallbladder and D2, allowing the passage of a large stone (Bouveret syndrome). The patient successfully underwent emergent arterial embolization guided by a clip endoscopically-placed near the duodenal fistulous orifice. There were no intercurrences or bleeding recurrence.
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References
1 - Muñoz-Villafranca C, García-Kamirruaga I, Gómez-García P, et al. Pseudoaneurysm of the cystic artery: An uncommon cause of upper gastrointestinal bleeding in a case of xanthogranulomatous cholecystitis. Rev Esp Enferm Dig 2015;107:375-376.
2 - Liu Y, Hsieh C, Yeh Y, et al. Cystic artery pseudoaneurysm: A case report. World J Clin Cases 2023;11:242-248. DOI: 10.12998/wjcc.v11.i1.242
3 - Taghavi SMJ, Kumar MJ, Prabha RD, et al. Cystic Artery Pseudoaneurysm: Current Review of Aetiology, Presentation, and Management. Surgery Research and Practice 2021,4492206. DOI: 10.1155/2021/4492206
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Sarmento Costa M, Gravito-Soares M, Gravito-Soares E, Figueiredo P. Unexpected cause of upper gastrointestinal bleeding: beyond the typical complications of gallstone disease. 10134/2023


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Publication history

Received: 03/12/2023

Accepted: 13/12/2023

Online First: 11/01/2024

Published: 10/10/2025

Article Online First time: 39 days

Article editing time: 677 days


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