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Figure 26c. Hemobilia due to posttraumatic pseudoaneurysm in a 31-year-old man with a grade IV liver injury. The patient was treated conservatively. Twenty days later, the patient presented with massive hematemesis. (a) Contrast-enhanced CT scan shows a round, high-attenuation lesion within the hepatic contusion (arrow). (b) Radiograph obtained after injection of contrast material through a microcatheter demonstrates a pseudoaneurysm (arrow) that arises from a superior segmental branch of the right hepatic artery. (c) Common hepatic angiogram obtained after embolization shows complete occlusion of the segmental branch of the right hepatic artery with microcoils (arrow). The clinical outcome was uneventful.
