Endovascular management of ruptured left gastric artery pseudoaneurysm giving rise to replaced left hepatic artery following radical cystectomy: A case report

Visceral artery pseudoaneurysms are rare and potentially fatal unless recognized and treated immediately. Here we present to our mind the first documented case of a ruptured pseudoaneurysm involving the left gastric artery giving rise to Michels’ Type II replaced left hepatic artery. An 84-year-old female presented with an acute rupture of such an aneurysm post radical cystectomy. CT Angiogram prior to intervention was key for appropriate catheter selection. Endovascular embolization proved effective, and the patient recovered unremarkably. The case report includes a brief discussion regarding the investigation and management of such ruptures, as well as the rarity of the variant anatomy described.