PMC7499336_01
Axial view of CT abdomen and pelvis with IV contrast. There is a pseudoaneurysm from the left hepatic artery going to the segment II, measuring approximately 1.4 cm x 1.8 cm x 1.9 cm. Also, pertinent for an extensive hemoperitoneum particularly around the liver, around the spleen, through right and left paracolic gutter, and in the pelvis.
CRIVAM2020-8835573.001.jpg
PMC7499336_01_CRIVAM2020-8835573.001.jpg
fig1
Emergent abdominal CT scan with contrast showed a left hepatic artery pseudoaneurysm associated with extensive hemoperitoneum (Figure 1), for which general surgery was consulted recommending an interventional radiology (IR) evaluation.
Hepatic and mesenteric arteriogram. Large pseudoaneurysm seen at the left hepatic artery to segment 2/3 of the liver (a). Postcoil embolization of the superselective branch of the left hepatic artery to segments 2/3 of the liver (b). Postembolization control run to the treated vessel showing decreased blood into the pseudoaneurysm and preserved blood flow into the segments 4a/4b of the liver (c). Final control run postcoil embolization showing no further filling of the pseudoaneurysm to segment 2/3 and preserved flow into the remaining left hepatic artery (d). Selective SMA run showing replaced right hepatic artery to the SMA with preserved flow into the right liver and no evidence of backdoor filling into the left hepatic artery pseudoaneurysm (e).
CRIVAM2020-8835573.002.jpg
PMC7499336_01_CRIVAM2020-8835573.002.jpg
fig2