Jaundice and bleeding caused by cystic artery pseudoaneurysm after cholecystectomy: A case report.

RATIONALE: Cystic artery pseudoaneurysm (PSA) after laparoscopic cholecystectomy is a rare but potentially fatal complication that can lead to both jaundice and gastrointestinal bleeding.

PATIENT CONCERNS: A 42-year-old woman, who was previously asymptomatic and undergoing a routine health examination, presented with jaundice and gastrointestinal bleeding 5 months after her laparoscopic cholecystectomy.

DIAGNOSES: Initial MRCP raised concerns for bile duct obstruction, prompting consideration of biliary trauma or tumor. However, contrast-enhanced CT and subsequent angiography revealed a 2.5 cm PSA at the previous cystic artery branch, compressing the bile duct.

INTERVENTIONS: The patient underwent transarterial embolization (TAE) using stainless steel coils to occlude the PSA and control bleeding. This minimally invasive procedure successfully addressed the vascular lesion.

OUTCOMES: Following TAE, the patient's jaundice resolved, liver function normalized, and gastrointestinal bleeding ceased. She recovered without complications and remained asymptomatic during a 1-year follow-up.

LESSONS: Early multimodal imaging is critical for identifying rare vascular complications, such as cystic artery PSA, following laparoscopic cholecystectomy, while prompt minimally invasive interventions are essential for preventing severe outcomes.