Pseudoaneurysm of the right hepatic artery and bile duct necrosis as a complication of acute cholecystitis in a diabetic patient

A very uncommon complication of acute cholecystitis is the development of a pseudoaneurysm in an arterial branch of the hepatic artery. We report a rare case of a patient with acute cholecystitis who presented with a pseudoaneurysm of the right anterior hepatic artery complicated by necrosis of the bile duct and hepatic infarction. A 70-year-old woman attended the emergency department with an unusual presentation of acute cholecystitis involving abdominal discomfort and a mass in the right upper quadrant. CT demonstrated a pseudoaneurysm of the right hepatic artery. Emergency selective transcatheter arterial embolization and cholecystectomy were performed. Subsequently, bile duct necrosis and hepatic ischemic damage made it necessary to perform a right hepatectomy and bile duct resection. Once a hepatic artery pseudoaneurysm is confirmed, its embolization may be useful to ensure the patient's safety. However, in our experience such pseudoaneurysms may be associated with hepatic and biliary ischemia.