Question:

Which of the following answer choice is false?
1. Hepatic angiography with embolisation has a lower morbidity and mortality rate when compared with surgical intervention.
2. Hepatic angiography can be used to identify the bleeding point.
3. Pseudonaneurysm can be injected with thrombin.
4. Cholecystectomy with ligation of the pseudoaneurysm remains the treatment of choice.
5. Pseudoaneurysms are hypodense pre-contrast with arterial enhancement.





Answer:

The correct answer for the question "Which of the following answer choice is false?" is:

5. Pseudoaneurysms are hypodense pre-contrast with arterial enhancement.



Explanation
a)    Hepatic angiography with embolisation has a lower morbidity and mortality rate when compared with surgical intervention (Hepatic angiography with embolisation in comparison to surgical management has a lower morbidity and mortality than surgery).

b)    Hepatic angiography can be used to identify the bleeding point (Hepatic angiography with embolisation in comparison to surgical management has a lower morbidity and mortality than surgery, with higher success rates in controlling haemorrhage and identifying the origin of bleeding).

c)    Pseudonaneurysm can be injected with thrombin (Definitive treatment of cystic artery pseudoaneurysms with percutaneous thrombin injection has been attempted, but failed after initial success).

d)    Cholecystectomy with ligation of the pseudoaneurysm remains the treatment of choice (The mainstay of treatment of cystic artery pseudoaneurysm is cholecystectomy with ligation of the cystic artery however the presence of inflammation poses the risk of bleeding and injury to adjacent visceral structures).

e)    Pseudoaneurysms are hypodense pre-contrast with arterial enhancement (Pseudoaneurysms on CECT are usually seen as hyperdense lesions without contrast and enhance in the arterial phase).



From the manuscript:
Successful Transcatheter Arterial Embolisation of a Cystic Artery Pseudoaneurysm Secondary to Calculus Cholecystitis: A Case Report
Radiology Case. 2010 Feb; 4(2):18-22


This article belongs to the Interventional section.




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From the manuscript

Successful Transcatheter Arterial Embolisation of a Cystic Artery Pseudoaneurysm Secondary to Calculus Cholecystitis: A Case Report

Free full text article: Successful Transcatheter Arterial Embolisation of a Cystic Artery Pseudoaneurysm Secondary to Calculus Cholecystitis: A Case Report

Abstract
Pseudoaneurysms of the cystic artery secondary to calculus cholecystitis are rare. In this report we describe a case of an elderly female who presented with abdominal pain, pyrexia, anaemia and jaundice. She had known chronic cholecystitis, but was not considered a suitable surgical candidate. Contrast enhanced computed tomography (CECT) demonstrated a probable aneurysm within the gallbladder fossa. The patient proceeded to digital subtraction angiography (DSA), which confirmed an aneurysm arising from the cystic artery and was subsequently managed with transcatheter arterial embolisation using coils. This case report reviews the diagnosis and management of this rare complication.






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