72-year-old male with a hepatic artery to portal vein fistula. This patient underwent PTBD placement for biliary diversion after a cholecystectomy led to a cystic duct stump leak. He had intermittent episodes of small volume hemobilia. (A) Computed tomography angiography (CTA) was performed and showed early opacification of a portal vein branch (curved arrow) for which he was referred for hepatic arteriogram. Celiac (B) and selective right hepatic (C) artery angiograms demonstrated hepatic artery (straight black arrows) to portal vein (curved black arrows) fistula, relatively remote from the PTBD. This injury was therefore thought to be related to initial needle passes. (D) The hepatic artery supplying this fistula was coil-embolized (white arrows). (E) Repeat hepatic angiogram demonstrated cessation of the arteriovenous fistula.