Figure 4.

Patient with a stab wound to the liver resulting in hemobilia. (A) Angiogram shows a large pseudoaneurysm (PSA) of a replaced left hepatic artery (arrow). Superselective catheterization was not possible due to severe spasm of the vessels. Percutaneous puncture with injection of thrombin under ultrasound guidance was performed. (B) Duplex ultrasound demonstrates flow in the PSA. (C) Duplex ultrasound after thrombin injection shows thrombosis of the PSA. (D) Angiogram after the embolization shows no filling of the PSA.