Question:

With regard to cystic artery pseudoaneurysms, which of the following answer choices is false?
1. Cystic artery pseudoaneurysms are a common complication of acute cholecystitis.
2. Upper gastrointestinal endoscopy may be helpful in active bleeding.
3. Colour Doppler US illustrates a vascular mass.
4. Colour Doppler may demonstrate the `ping-pong` sign.
5. Pseudoaneurysms may rupture due to vessel wall weakness.





Answer:

The correct answers for the question "With regard to cystic artery pseudoaneurysms, which of the following answer choices is false?" are:

1. Cystic artery pseudoaneurysms are a common complication of acute cholecystitis.

4. Colour Doppler may demonstrate the `ping-pong` sign.



Explanation
a)    Cystic artery pseudoaneurysms are a common complication of acute cholecystitis (Pseudoaneurysms of the cystic artery secondary to acute or chronic cholecystitis are rare despite the high incidence of cholecystitis, although the reasons for this are unclear)

b)    Upper gastrointestinal endoscopy may be helpful in active bleeding (Upper gastrointestinal endoscopy does not usually reveal abnormalities in the stomach and duodenum, unless there is active bleeding with haemorrhage through the ampulla of Vater).

c)    Colour Doppler US illustrates a vascular mass (Colour Doppler US is the modality of choice in suspected pseudoaneurysm as it successfully demonstrates the vascular nature of the mass).

d)    Colour Doppler may demonstrate the `ping-pong` sign (Colour Doppler US is the modality of choice in suspected pseudoaneurysm as it successfully demonstrates the vascular nature of the mass and may demonstrate the `yin-yang` sign that is characteristic of pseudoaneurysms).

e)    Pseudoaneurysms may rupture due to vessel wall weakness (A pseudoaneurysm or false aneurysm, is an outpouching of a blood vessel which arises as a consequence of visceral inflammation next to the arterial wall, leading to damage of the adventitia and thrombosis of the vasa vasorum resulting in localized weakness in the vessel wall making it prone to rupture).



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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