Post-traumatic hepatic artery pseudoaneurysm treated with endovascular embolization and thrombin injection

Figure 1 CT and angiography images. A: contrast enhanced CT revealing a collection filled of contrast at the hepatic hilium compatible with pseudoaneurysm and dilated intrahepatic bile duct; B: Selective arteriography of the celiac trunk showing the pseudoaneurysm arising from the common hepatic artery; C: Angiography of the common hepatic artery after embolization. No fill of the pseudoaneurysm is visible from this artery; D: Selective superior mesenteric artery arteriography three days after embolization. The pseudoaneurysm (white arrows) is partly thrombosed with persistence of filling from thin branches. The superselective catheterization of these vessel wasn´t possible due its tortuosity and narrow caliber.

Figure 2 Ultrasound guided thrombin injection. A: Color doppler ultrasound. A small cavity persists with flow in the pseudoaneurysm; B: Needle inside the pseudoaneurysm immediately after the injection of thrombin showing the absence of flow (thrombosis).

Figure 3 CT scan 12 mo after treatment. Complete thrombosis of the pseudoaneurysm and no dilation of the biliary tract are observed.