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Case Reports
. 2025 Aug 6;2025(8):rjaf603.
doi: 10.1093/jscr/rjaf603. eCollection 2025 Aug.

Anterior right hepatic artery pseudoaneurysm secondary to biliary tract instrumentation treated by angioembolization

Carmen Judith Roca Vásquez  1   2 , Carlos Alberto Córdova Velázquez  1   2 , Gabrielle Nandayapa Pérez  1   2 , Ratziel Alberto Lezama Molina  1   2 , Jorge Alberto Roldán García  1   2 , Oscar Chapa Azuela  1   2
Affiliations
Case Reports

Anterior right hepatic artery pseudoaneurysm secondary to biliary tract instrumentation treated by angioembolization

Carmen Judith Roca Vásquez et al. J Surg Case Rep. .

Abstract

Hepatic artery pseudoaneurysm is a rare complication following biliary tract instrumentation. Clinical presentation may range from asymptomatic course to catastrophic hemorrhage with high morbidity and mortality. We report a case of anterior right hepatic artery pseudoaneurysm secondary to surgical instrumentation. A 71-year-old woman underwent hepaticojejunostomy due to a Strasberg E5 bile duct injury. In the postoperative period, she presented with gastrointestinal bleeding and hemodynamic instability. Angio-CT revealed a saccular lesion in a branch of the right hepatic artery (Segment V). Angiography confirmed the diagnosis, and selective embolization of the pseudoaneurysm was successfully performed using microcoils. This case illustrates a rare complication following biliary tract instrumentation and discusses diagnostic and therapeutic options for hepatic artery pseudoaneurysms.

Keywords: angioembolization; hepatic artery; hepaticojejunostomy; pseudoaneurysm.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Angiotomography. (a) Axial slice showing a saccular image (arrow) with an aneurysmal appearance, 8 × 5 mm in size, originating from the right hepatic artery (Segment V), with no evidence of active bleeding. (b) Coronal slice showing a pseudoaneurysm (arrow) in the branch of the right hepatic artery (Segment V).
Figure 2
Figure 2
Angiography. (a) Saccular image consistent with a hepatic artery pseudoaneurysm (Segment V). (b) Pre-embolization image of the right hepatic artery showing contrast medium leakage (arrow) from a branch (Segment V) of the right hepatic artery. Right percutaneous catheter (star).
Figure 3
Figure 3
Transcatheter arterial embolization of the right hepatic artery. (a) Selective transcatheter arterial embolization (TAE) of the branch of the right hepatic artery (Segment V) (arrow). (b) Post-embolization image of the pseudoaneurysm in the branch (Segment V) of the right hepatic artery with microcoils (arrow), showing no contrast medium leakage. Right percutaneous catheter (star).
Figure 4
Figure 4
Supranastomotic percutaneous transcatheter cholangiography. Hepaticojejunostomy (arrowhead), microcoils (arrow), and percutaneous catheter (star).
See this image and copyright information in PMC

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