Management of a common hepatic artery pseudoaneurysm after blunt trauma

© Author(s) (or their employer(s)) 2022. Reuse permitted under CC BYNC. No commercial reuse. See rights and permissions. Published by BMJ. CASE PRESENTATION A 34yearold pedestrian was struck by a vehicle and presented with epigastric tenderness. He underwent an abdominal CT scan which showed a moderatesized peripancreatic hematoma and a focal interruption of the proximal common hepatic artery without extravasation. He was transferred to our center and arrived in stable condition. Magnetic resonance angiography (MRA) and cholangiopancreatography (MRCP) was obtained and it redemonstrated segmental occlusion of the proximal common hepatic artery with collateral flow from the gastroduodenal artery. There was no evidence of a pancreatic injury (figure 1A,B). One week later, a surveillance abdominal computerized tomography angiography (CTA) demonstrated interval development of a 3.2×2.2 cm common hepatic artery pseudoaneurysm just distal to its takeoff from the celiac artery (figure 2). Immediately after CT, he became unresponsive with a systolic blood pressure of 60 mm Hg.