PMC5356167_01
Endoscopy showing the blood clot emanating from the major papilla (arrow).
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F1
Endoscopic retrograde cholangiopancreatography (ERCP) revealed a large blood clot emerging from the biliary orifice (Figure 1).
Multiphasic abdominal CT series showing a 13 x 6-mm pseudoaneurysm in the region of the cystic artery adjacent to the cholecystectomy clips (arrows).
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F2
A computed tomography (CT) angiogram revealed a 13 x 6-mm pseudoaneurysm arising in the region of the cystic artery adjacent to the cholecystectomy clips (Figure 2).
(A) Celiac arteriogram in late arterial phase showing contrast opacifying the pseudoaneurysm (arrow). The arterial source could not be found despite multiple sub-selective arteriograms. (B) Fluoroscopy spot film showing contrast injection through the percutaneous needle into the pseudoaneurysm just before embolization.
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F3
This was confirmed on visceral angiography (Figure 3); however, the artery feeding the pseudoaneurysm could not be identified for embolization.