Replaced right hepatic artery pseudoaneurysm managed with coil embolisation

Abstract

A 20-year-old male patient presented to our emergency surgery department with blunt trauma to the abdomen and in a state of shock. The patient was resuscitated and a Contrast-Enhanced Computed Tomography (CECT) was done which showed a grade 2 liver injury involving segment VIII. The patient was managed conservatively and discharged after 8 days. The patient again presented after 3 weeks with severe anaemia, fever and melena. An upper gastrointestinal endoscopy revealed bile mixed with blood at the ampulla of Vater, consistent with haemobilia. CT angiography showed grade 2 injury of the liver with large haematoma in segment VIII. A large right subcapsular collection, a saccular area consistent with pseudoaneurysm of the replaced right hepatic artery arising from the superior mesenteric artery, was seen. A replaced left hepatic artery arising from the left gastric artery was also observed. The patient underwent right hepatic artery coil embolisation, with postprocedure digital subtraction scan showing no extravasation of contrast. The patient recovered well in the follow-up.

Case report: Recurrent hemobilia due to hepatic artery pseudoaneurysm mimicking gastrointestinal tract bleeding

“…However, most stents could not be implanted satisfactorily because of the tortuous access of the right hepatic artery and the poor compliance of the stent. Consistent with the previous similar case reported by Bains ( 20 ), we also performed emergency arterial embolization. Postoperatively, the boy was completely asymptomatic and there was no enhancing pseudoaneurysm on abdominal CECT.…”

Ruptured gastric artery aneurysms in polyarteritis nodosa successfully treated with embolization

“…[8] Despite the possibility of complications, coil embolization was associated with a shorter hospital stay than surgical treatment and a significant reduction in morbidity and mortality rates of 25% and 67%, respectively. [9,10] This patient suffered from ruptured gastric artery aneurysms, resulting in hemorrhagic shock. Fortunately, PVA combined with coil embolization of the ruptured aneurysm was performed successfully with no complications.…”

Replaced right hepatic artery arising from abdominal aorta: a case report

“…Interventional radiology may encounter difficulties in dealing with aneurysms of aberrant arteries, especially when embolism is necessary 11 . Vascular injury may occur during pancreatoduodenectomy, cholecystectomy and pancreatectomy.…”