Late presentation of hepatic pseudoaneurysm after liver trauma: a case of misdiagnosed cholecystitis and successful endovascular embolization

Abstract

Hepatic artery pseudoaneurysms are a significant health concern, often incidentally discovered during computed tomography (CT) scans, as their exact incidence rate remains unknown. The most common symptoms of a pseudoaneurysm are hematemesis, abdominal pain, anemia and jaundice. A triad of right upper quadrant pain, jaundice and overt upper gastrointestinal bleeding is a classic presentation of the condition, which occurs in only a third of patients with hemobilia. Patients have a high risk of rupture, and an endovascular approach with coil embolization is recommended. A case of a 28-year-old woman with a post-traumatic hepatic pseudoaneurysm is presented in which she was initially misdiagnosed and treated for cholecystitis. After the development of jaundice, hematemesis and melena, a CT angiography confirmed diagnosis. Endovascular embolization was performed successfully, and the patient recovered without complications. This case highlights the importance of prompt diagnosis of hepatic pseudoaneurysms, as a delayed diagnosis can result in significant morbidity and mortality.