Objective:

To report a case of hepatic artery pseudoaneurysm with arterioportal fistula following penetrating liver trauma and to review relevant literature.

Approach:

• Case Presentation: A 25-year-old male with a stab wound underwent exploratory laparotomy for a grade III left hepatic lobe laceration. Postoperative complications included persistent blood-tinged drain output and epigastric pain.
• Diagnostic Imaging: Contrast-enhanced CT and angiography confirmed a left hepatic artery pseudoaneurysm with an associated arterioportal fistula.
• Treatment: Initial Gelfoam embolization failed; however, definitive coil embolization via the femoral artery successfully excluded the lesion and resolved the fistulous communication.

Key Findings:

• Hepatic artery pseudoaneurysm with arterioportal fistula is a rare complication of penetrating liver trauma.
• Early identification and prompt endovascular management are essential to prevent severe outcomes.
• Endovascular coil embolization is a safe and effective treatment for this condition.

Interpretation:

This case emphasizes the need for awareness of delayed vascular complications following penetrating liver trauma.

Limitations:

• The rarity of the condition limits the generalizability of findings.
• The case report format may not capture all potential complications or outcomes.

Conclusion:

Structured postoperative follow-up is crucial for monitoring patients with hepatic artery pseudoaneurysm.