Anterior right hepatic artery pseudoaneurysm secondary to biliary tract instrumentation treated by angioembolization

Abstract Hepatic artery pseudoaneurysm is a rare complication following biliary tract instrumentation. Clinical presentation may range from asymptomatic course to catastrophic hemorrhage with high morbidity and mortality. We report a case of anterior right hepatic artery pseudoaneurysm secondary to surgical instrumentation. A 71-year-old woman underwent hepaticojejunostomy due to a Strasberg E5 bile duct injury. In the postoperative period, she presented with gastrointestinal bleeding and hemodynamic instability. Angio-CT revealed a saccular lesion in a branch of the right hepatic artery (Segment V). Angiography confirmed the diagnosis, and selective embolization of the pseudoaneurysm was successfully performed using microcoils. This case illustrates a rare complication following biliary tract instrumentation and discusses diagnostic and therapeutic options for hepatic artery pseudoaneurysms.