F A

M VH

Fig. 3.20 Liver trauma, pseudoaneurysm. Dense intra-parenchymal contrast blush (in the arterial phase) adjacent to the liver haematoma - 8 days following the initial injury.

fistula formation, e.g. arterio-portal fistula. Pseudoaneurysms appear as intense foci of contrast enhancement seen best on arterial phase imaging (see Fig. 3.20). These can be treated with coil embolisation (see Figs 3.21 and 3.22). Early intervention with coil embolisation, percutaneous drainage, ERCP and stenting of bile duct injuries has helped 144 reduce the proportion of patients requiring surgery following liver trauma.

Fig. 3.21 Blunt abdominal trauma, liver trauma. Right hepatic artery angiogram demonstrating pseudoaneurysm.

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