Figure 3
From: Complications of high grade liver injuries: management and outcomewith focus on bile leaks
16 year old male sustained a gunshot wound to the right upper abdomen. He was managed non-operatively. Right hepatic artery pseudoaneurysm (PSA) was found on CT performed due to fever, billious discharge from the exit wound and pain on PID 16. Two days after successful AE he had an episode of external bleeding from the same bullet wound. Recurrent PSA was found on repeat angiography. Repeat AE was performed successfully. A: Contrast-enhanced CT scan obtained on PID 16 shows a newly developed, well-circumscribed PSA (arrow) within the perihepatic abscess containing air bubbles. B: On selective arteriogram, the PSA (arrow) is seen to arise from the right hepatic artery. C: Recurrent PSA found 2 days after previous AE. Coils are seen in the artery (arrow). D: Angiogram after successful AE.