Role of sonography in the diagnosis and treatment of a large iatrogenic pseudoaneurysm of a hepatic artery.

We report the sonographic (US) findings in a case of successful combined endovascular and percutaneous treatment of a large hepatic artery pseudoaneurysm, responsible of massive hemobilia, in a patient with coexisting portal vein thrombosis. Previous percutaneous transhepatic biliary drainage placement caused the pseudoaneurysm. US identified the pseudoaneurysm and showed the biliary drain crossing the pseudoaneurysm lumen. After partial endovascular coils embolization of the pseudoaneurysm lumen, the biliary catheter was removed and the entry site of the catheter in the aneurysmal sac was occluded with an Amplatzer vascular plug released under US guidance. The residual lumen was then completely embolized with coils and Lipiodol.