Hepatic artery pseudoaneurysm

The case demonstrates a rare, potentially fatal complication of cholecystectomy, that is iatrogenic hepatic arterypseudoaneurysm, which occurred in this patient after a laparoscopic approach that converted to open surgery after recognizing the complication during surgery. noteNote the variant anatomy of common hepatic artery origin.

 The interventional radiologist was consulted. 

_{Case courtesy of Prof.Mohammed A. Al-jiboori, consultant radiologist.}

A well-defined oval-shaped intensely enhancing lesion is noted at the porta hepatis. It follows the arterial density in the arterial, venous and delayed phases in keeping with an arterial lesion. In the context of preceding surgery to the region, the diagnosis of hepatic artery pseudoaneurysm is established. No signs of rupture, no free fluid.

Thick-walled subhepatic fluid collection with internal debris associated with few air loculi seen at the non-dependent portion, likely representing infected subhepatic collection (abscess).

Aberrant origin of common hepatic artery from the SMA rather than from coeliac trunk.

Mildly dilated IHBRsintrahepatic bile ducts.

Cholecystectomy clips and drain are also visualized.