Pseudoaneurysm in gall bladder fossa following laparoscopic cholecystectomy.

A 32-year-old lady presented with severe hematemesis and melena after laparoscopic cholecystectomy. Initial ultrasonography and spiral CT suggested a vascular lesion in the gall bladder fossa. Selective hepatic angiography confirmed the presence of a pseudoaneurysm close to the surgical clip and filling through the right hepatic artery. This was treated with coil embolization, resulting in cessation of hematemesis and amelioration of symptoms.

Aortoarteritis of abdominal aorta: an angiographic profile in 110 patients.

The angiographic appearances in 110 patients (49 males, 61 females, age range 11-46 years, mean 27.8 years) with aortoarteritis involving the abdominal aorta and/or its branches were analysed. There were 41 aneurysms of the abdominal aorta in 37 patients and eight aneurysms of its branches in as many patients. In 50 patients, 53 obstructive lesions involved the abdominal aorta and were classified as stenoses of focal, segmental and diffuse types and total occlusions. Branch obstructions (182 lesions in 85 patients) affected in order of frequency, the renal, superior mesenteric, coeliac, iliac and the inferior mesenteric arteries. Mesenteric arterial lesions were significantly more common in males (P = 0.01). Collateral circulation through a prominent mesenteric arcade was a distinctive angiographic feature in 28 patients. Computed tomography done in four patients showed peri-adventitial thickening and layered thrombus within aneurysms in three patients, and luminal occlusion of the upper abdominal aorta in one patient. Angiographic appearances in aortoarteritis of the abdominal aorta are characteristic and sufficiently distinctive for definitive diagnosis and appropriate management.