“Beyond saving lives”: Current perspectives of interventional radiology in trauma

Figure 3 Gun shot injury with hepatic artery pseudoaneurysm. A 38-year male with gunshot injury presented after a week with falling hematocrit. A: CECT showed a contrast filled outpouching in segment VIII of liver paralleling the attenuation of adjacent hepatic artery branch s/o PsA (arrow) with adjacent subscapular hematoma (arrowhead) subsequently DSA was done; B: Initial hepatic angiogram showed opacification of only branches of left lobe of liver,no opacification of right hepatic artery -s/o variant anatomy; C: SMA angiogram showed replaced right hepatic artery with PsA arising from the terminal end of anterior division (arrow). Due to smaller caliber and spasm, neck of the PsA could not be negotiated, hence, proximal embolization with microcoils was performed; D: Post embolization angiogram showed faint opacification of branches of anterior division of RHA alongwith exclusion of PsA. CECT: Contrast enhanced computed tomography; RHA: Right hepatic artery; PsA: Pseudoaneurysm; SMA: Superior mesentery artery; DSA: Digital subtraction angiography.