Treatment of hemorrhagic right gastro-omental artery pseudoaneurysm via ultrasound guided percutaneous thrombin injection

Visceral artery pseudoaneurysms are life-threatening conditions due to their high risk of rupture and hemorrhage. Traditional treatments include endovascular interventions such as stent grafting and embolization, or open surgery. However, ultrasound-guided percutaneous thrombin injection is rarely used as a first-line therapy. This case report presents a 66-year-old patient with an iatrogenic hemorrhagic pseudoaneurysm of the right gastro-omental artery, successfully treated with ultrasound-guided percutaneous thrombin injection. Under local anesthesia, a 5 mL bolus of thrombin was injected into the pseudoaneurysm sac, resulting in immediate thrombosis confirmed by ultrasound and Doppler imaging. The patient demonstrated stable hemodynamics and hemoglobin levels post-procedure. Follow-up imaging showed significant regression of hemorrhagic fluid and no contrast extravasation. This case highlights ultrasound-guided thrombin injection as a safe, cost-effective, and radiation-free alternative to traditional treatments for selected visceral artery pseudoaneurysms, particularly in distal branches or emergency settings.