Transcatheter Arterial Embolization of Pseudoaneurysm after Endoscopic Ultrasound-guided Hepaticojejunostomy: A Case...

Endoscopic ultrasonography-guided biliary drainage has been reported as an alternative technique when transpapillary endoscopic biliary drainage fails. This case study describes a case of pseudoaneurysm, one of the complications unique to endoscopic ultrasonography-guided biliary drainage. An 87-year-old woman who underwent endoscopic ultrasonography-guided hepaticojejunostomy with a partially covered metallic stent developed hematochezia. Contrast-enhanced computed tomography revealed a pseudoaneurysm of the left hepatic artery adjacent to the stent. During coil embolization, angiography revealed bleeding, passing through the covered portion of the stent into the jejunum, and coil embolization was successfully performed. In cases after bile duct stent placement, where a tamponade effect can be expected, hepatic artery pseudoaneurysm may occur as a complication of puncture, and embolization may be required.