Случай рецидива травматической гемобилии после селективной эмболизации сегментарной печеночной артерии

Abstract

The article describes a rare case of recurrent hemobilia after previously performed selective embolization
of a segmental hepatic artery. A 33-year-old man underwent open (laparotomic) suturing of the injury due
to a rupture of segments VI-VII of the liver, but 3 weeks after the operation, the patient developed signs of
gastrointestinal bleeding. According to the results of ultrasound, duodenoscopy, MSCT and celiacography, a
false aneurysm of the segmental artery of the VII-VIII segments of the liver was revealed, in connection with
which the embolization of the feeding artery was performed, and hemobilia was stopped. Two weeks after
embolization, a recurrence of hemobilia was noted; repeated celiacography revealed an arteriobiliary fistula
through the wall of a false aneurysm. Selective catheterization of the artery of the right lobe of the liver was
performed and embolization was performed - a complete shutdown of the target artery was achieved, however,
there was a flow of contrast into the aneurysm through collaterals from the arteries of the left lobe of the liver,
which required additional embolization of the artery of the left lobe of the liver. After the procedure, the signs
of gastroduodenal bleeding stopped.