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Case Reports
. 2025 Jul 31;17(7):e89125.
doi: 10.7759/cureus.89125. eCollection 2025 Jul.

Right Hepatic Artery Pseudoaneurysm Following Laparoscopic Cholecystectomy: A Rare Complication Treated With Coil Embolization

Vishal Babbar  1 , Ronit Biswas  1 , Aneesh Kumar  1 , Sweta Kumari  1 , Arvind Pratap  1 , Pramod K Singh  2 , Vivek Srivastava  1 , Mumtaz A Ansari  1
Affiliations
Case Reports

Right Hepatic Artery Pseudoaneurysm Following Laparoscopic Cholecystectomy: A Rare Complication Treated With Coil Embolization

Vishal Babbar et al. Cureus. .

Abstract

Hepatic artery pseudoaneurysm (HAPA) is an uncommon but potentially life-threatening vascular complication following laparoscopic cholecystectomy, often presenting days to weeks postoperatively. We describe the case of a 34-year-old female patient who presented 45 days following surgery with recurring hematemesis, melena, abdominal pain, and jaundice. Ultrasonography with colour Doppler suggested a vascular lesion near the porta hepatis, and triple-phase CT angiography confirmed a right hepatic artery (RHA) pseudoaneurysm leading to intrahepatic biliary radical dilatation (IHBRD). The patient underwent successful coil embolization, leading to full recovery without complications. HAPA should be considered in post-cholecystectomy patients who exhibit upper gastrointestinal (GI) hemorrhage or hemobilia. Early imaging diagnosis using Doppler ultrasound and CT angiography is imperative for timely intervention. Coil embolization provides a minimally invasive, effective alternative to open surgical repair, reducing associated morbidity and mortality. This case underscores the importance of prompt recognition and endovascular management of vascular complications following biliary surgery to prevent fatal outcomes.

Keywords: case report; coil embolization; hepatic artery injury; laparoscopic cholecystectomy; pseudoaneurysm; right hepatic artery.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. USG of the whole abdomen and color Doppler: moderate intrahepatic biliary radical dilatation (IHBRD) noted (central, bilobar); at the porta, a hypoechoic cystic lesion noted with the yin-yang sign on color Doppler, with the possibility of a pseudoaneurysm arising from the hepatic artery.
Figure 2
Figure 2. Triple-phase CT abdomen with angiography (arterial phase) demonstrating a well-defined right hepatic artery pseudoaneurysm (marked with a red star), 4 x 3 cm in size, neck diameter approx. 4 mm (marked with a blue arrow), 1.9 cm distal to the origin from the common hepatic artery, showing intense enhancement in the arterial phase with persistent enhancement in the venous phase. Bilobar intrahepatic biliary radical dilatation (IHBRD) (left > right) due to compression by right hepatic artery pseudoaneurysm
Figure 3
Figure 3. Three-dimensional volume rendering technique (3D-VRT) reconstructed contrast-enhanced CT (CECT) shows a pseudoaneurysm in the right hepatic artery territory.
Figure 4
Figure 4. Pre-coiling digital subtraction angiogram showing contrast-filled outpouching (blush) in the right hepatic artery territory, marked with a red arrow, confirming a pseudoaneurysm.
Figure 5
Figure 5. Post-coiling angiogram showing complete occlusion of the right hepatic artery pseudoaneurysm (HAPA), with no residual contrast blush, confirming effective coil embolization
See this image and copyright information in PMC

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References

    1. Radiological diagnosis and management of postlaparoscopic cholecystectomy right hepatic arterial pseudoaneurysm: a case report. Bhusal A, Jha SK, Oli R, Paudel B, Ghimire P. https://doi.org/10.1016/j.radcr.2024.09.005. Radiol Case Rep. 2024;19:6259–6264. - PMC - PubMed
    1. Hepatic artery pseudoaneurysm presenting as gastrointestinal hemorrhage. Singh P, Scibelli N, Gosal K, Bostick A, Morgan DC. Cureus. 2021;13:0. - PMC - PubMed
    1. Newer anatomy of the liver and its variant blood supply and collateral circulation. Michels NA. https://doi.org/10.1016/0002-9610(66)90201-7. Am J Surg. 1966;112:337–347. - PubMed
    1. Surgical anatomy of the hepatic arteries in 1000 cases. Hiatt JR, Gabbay J, Busuttil RW. https://journals.lww.com/annalsofsurgery/abstract/1994/07000/surgical_an.... Ann Surg. 1994;220:50–52. - PMC - PubMed
    1. Right hepatic artery pseudoaneurysm post-laparoscopic cholecystectomy: a case report of endovascular stent-graft management. Ahmed S, Filep R, Mushtaq A, Budisca O. https://doi.org/10.7759/cureus.57127 Cureus. 2024;16:0. - PMC - PubMed

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