Figure 1
(A) Contrast-enhanced CT in an oblique coronal plan (MinIP recontruction) showing the right hepatic artery aneurysm at the level of the ampulla of Vater (arrow). Proximal dilation of the common bile duct is suggestive for obstruction. (B) VRT reconstruction showing a segment of the abdominal aorta with its branches: the celiac trunk, the superior mesenteric artery, from which the hepatic artery arises with the aneurysm (arrow), and the renal arteries.
Figure 2
(A) Fluoroscopy images showing the endovascular catheterization of the hepatic artery and the aneurysm. (B) Situation after insertion of an expandable stent over the aneurysm, excluding it from the circulation.
Figure 3
(A) Cholangiography images during the ERCP procedure showing dilated intra- and extrahepatic bile ducts with a persisting impression of the stented right hepatic artery aneurysm sac on the distal common bile duct (arrow). Multiple gallstones are in the gallbladder. (B) Situation after placement of a metal stent in the common bile duct.
Figure 4
Graph showing the evolution of the total bilirubin plasma level reflecting cholestasis in function of time. After the aneurysm stenting on 27 June 2024, an evident decrease in cholestasis is noted. This decrease levels out after placement of the metal stent in the common bile duct on 4 July 2024.