Intrahepatic Artery Pseudoaneurysm as a Delayed Presentation of Blunt Abdominal Trauma


1 General Surgery Specialist, Pancreatic and Hepatobiliary and Transplant Subspecialist, Assistant Professor, Isfahan University of Medical Sciences, Isfahan, IR Iran

2 General Surgery Specialist, Thoracic Surgery Subspecialist, Associate Professor of Isfahan University of Medical Sciences, Isfahan, IR Iran

3 MD, Department of General Surgery, Isfahan University of Medical Sciences, Isfahan, IR Iran



Arterial pseudoaneurysm is an uncommon life-threatening complication in blunt trauma patients. Blunt liver injury may lead to hepatic artery pseudoaneurysm. Radiological intervention is the method of choice in diagnosis and treatment of hepatic artery pseudoaneurysm. However, surgical intervention is advised for unstable patients with large leaking defects. This study reports a case of 53-year-old female who was admitted with vague abdominal pain. She had experienced a blunt abdominal trauma a year ago and had gone under liver packing procedure. The CT-scan results showed hematoma in RUQ region and leaking pseudoaneurysm of right hepatic artery. Hematoma was drained and partial liver resection and hepatic arterioraphy were done through laparotomy.


1. Sun L, Guan YS, Wu H, Pan WM, Li X, He Q, et al. Post-traumatic hepatic artery pseudo-aneurysm combined with subphrenic liver abscess treated with embolization. World J Gastroenterol. 2006;12(17):2798–9. [PubMed: 16718774].
2. Luo X, Tan S, Wang J, Qian C. Upper gastrointestinal hemorrhage from hepatic artery pseudoaneurysm secondary to trauma: a case report. Med Princ Pract. 2010;19(6):493–5. doi: 10.1159/000320311. [PubMed: 20881420].
3. Tsurukiri J, Ueno M. Early multiple intrahepatic artery pseudoaneurysm formation after liver trauma. Clin Gastroenterol Hepatol. 2011;9(10):e106–7. doi: 10.1016/j.cgh.2011.06.001. [PubMed: 21699812].
4. Mate AD, Surnare KR, Deolekar SS, Gvalani AK. Lower gastrointestinal bleeding due to hepatic artery pseudoaneurysm following laparoscopic cholecystectomy. J Minim Access Surg. 2013;9(1):31–3. doi: 10.4103/0972-9941.107135. [PubMed: 23626418].
5. Cambj–Sapunar L, Piplovic–Vukovic T, Simunic M, Ardalic Z, Tonkic A, Perkovic N, et al. Posttraumatic hepatic artery pseudoaneurysm presenting as gastrointestinal bleeding. J Intens Care Emerg Med. 2014;9(1):57–9. doi: 10.22514/sv91.042014.11.
6. Batur A, Yavuz A, Toktas O, Bora A, Bulut MD. Hepatic Artery Pseudoaneurysm: Delayed Presentation after a Blunt Trauma. Pol J Radiol. 2015;80:334–6. doi: 10.12659/PJR.894177. [PubMed: 26171087].
7. Osterballe L, Helgstrand F, Axelsen T, Hillingso J, Svendsen LB. Hepatic pseudoaneurysm after traumatic liver injury; is CT follow-up warranted? J Trauma Manag Outcomes. 2014;8:18. doi: 10.1186/1752-2897-8- 18. [PubMed: 25780384].
8. Bashiri K, Roushan N, Hamidian SM. Hepatic Artery Pseudoaneurysm; Simple or Difficult to Diagnose? Arch Iran Med. 2016;19(7):521–2. [PubMed: 27362248].
9. Brandt AH, Ewertsen C, Hansen KL. The Impact of Transient Hepatic Attenuation Differences in the Diagnosis of Pseudoaneurysm and Arteriovenous Fistula on Follow-Up CT Scans after Blunt Liver Trauma. Diagnostics (Basel). 2014;4(3):129–39. doi: 10.3390/diagnostics4030129. [PubMed: 26852681].
10. Iswanto S, Nussbaum ML. Hepatic artery pseudoaneurysm after surgical treatment for pancreatic cancer: minimally invasive angiographic techniques as the preferred treatment. N Am J Med Sci. 2014;6(6):287–90. doi: 10.4103/1947-2714.134377. [PubMed: 25006566].
 11. Kumar A, Ahuja CK, Vyas S, Kalra N, Khandelwal N, Chawla Y. Hepatic arteriovenous fistulae: role of interventional radiology. Digest Dis Sci. 2012;57(10):2703–12.
12. Karangelis D, Daskalopoulos M, Giamouzis G, Koufakis T, Fragoulis S, Papadakis E, et al. Acute aortic dissection is independent of weather conditions but statistically correlates with day of the week. J Emerg Trauma Shock. 2014;7(3):244–6. doi: 10.4103/0974-2700.136877. [PubMed: 25114440].
13. Francisco LE, Asuncion LC, Antonio CA, Ricardo RC, Manuel RP, Caridad MH. Post-traumatic hepatic artery pseudoaneurysm treated with endovascular embolization and thrombin injection. World J Hepatol. 2010;2(2):87–90. doi: 10.4254/wjh.v2.i2.87. [PubMed: 21160978].
14. Aboujaoude M, Noel B, Beaudoin M, Ghattas G, Lalonde L, The Bao B, et al. Pseudoaneurysm of the proper hepatic artery with duodenal fistula appearing as a late complication of blunt abdominal trauma. J Trauma. 1996;40(1):123–5. [PubMed: 8576975].
15. Zhang X, Li X. Successful Embolization of a Huge Hepatic Artery Pseudoaneurysm after Blunt Abdominal Trauma. J Pediatr. 2016;168:252–e1. doi: 10.1016/j.jpeds.2015.09.052. [PubMed: 26490131].
 16. Yi IK, Miao FL, Wong J, Narasimhan KL, Lo RH, Yee L, et al. Prophylactic embolization of hepatic artery pseudoaneurysm after blunt abdominal trauma in a child. J Pediatr Surg. 2010;45(4):837–9. doi: 10.1016/j.jpedsurg.2010.01.021. [PubMed: 20385298].
17. Gondolesi GE, Matsumoto C, Wayne M, Schwartz ME. Post-traumatic pseudoaneurysm of the common hepatic artery with duodenal fistula. HPB (Oxford). 2002;4(4):183–6. doi: 10.1080/13651820260503855. [PubMed: 18332952].
18. Baha B, Meyer PG, Brunelle F, Orliaguet G, Michel JL, Carli P. [A case of hepatic pseudoaneurysm treated with percutaneous embolization in a child with multiple trauma]. Ann Fr Anesth Reanim. 2001;20(9):786– 90. [PubMed: 11759319].
19. Jones PM, Subbarao G. Hemobilia caused by hepatic artery pseudoaneurysm following abdominal trauma. J Pediatr Gastroenterol Nutr. 2015;60(5):ee40. doi: 10.1097/MPG.0b013e31829ce596. [PubMed: 23752076].