A 36-year-old woman with a history of open cholecystectomy 4 years ago, who came to the emergency department for a 3-month history of intermittent abdominal pain in the epigastric region and referred symptomatic vomiting due to right hypochondrium.
On physical examination, the patient was afflicted with hemodynamically stable mild pain due to deep hypothermia with no signs of peritoneal irritation.
Laboratory tests showed no abnormalities.
An ultrasound was performed and subsequently an abdominal computed tomography (CT) revealed dilation of the own hepatic artery close to its bifurcation compatible with a pseudoaneurysm, with a wall compression of 1.5 cm and a biliary tract component.
The next day, selective angiography of the celiac trunk was performed via the right femoral artery, common hepatic artery and superior mesenteric artery aiming at a saccular aneurysm at the bifurcation of the hepatic artery, with intrahepatic distal vascularization.
It was decided to place a self-expanding metallic prosthesis and embolization of the pseudoaneurysm using coils with effective occlusion and no complications in the control.
On the third day of his stay in the Resuscitation Service, he presented with pain and sudden hypotension secondary to rupture of the aneurysm into the peritoneal cavity, and the patient died during surgery.
