Hepatic artery pseudoaneurysm following laparoscopic cholecystectomy: transcatheter intraarterial embolization

We present a case of hepatic artery injury with pseudoaneurysm formation following laparoscopic cholecystectomy. A 29-year-old man was referred to our hospital with right upper quadrant pain, jaundice and upper gastrointestinal bleeding one month after laparoscopic cholecystectomy. Gastroscopy showed mucosal erosions at the gastroesophageal junction. The patient did well after medical treatment only and was discharged one week later. However, ten days later he was readmitted with recurrent upper gastrointestinal bleeding. Usual laboratory tests, routine imagine diagnostic procedures and selective hepatic arteriogram were performed. Usual laboratory tests and routine imagine diagnostic procedures were inconclusive, but selective hepatic arteriogram showed a right hepatic artery pseudoaneurysm. The diagnosis of hemobilia was established. Embolization of the aneurysm with coils was carried out. Bleeding was controlled, the patient was discharged one week later and since then he remains under close follow up without any evidence of bleeding recurrence. We believe that the intraarterial embolization of a pseudoaneurysm is a safe and effective method to manage some complications such as bleeding or hemobilia.