A 74-year-old woman underwent pancreatoduodenectomy for a carcinoma of the common bile duct. On the 7th postoperative day, there was sudden onset of bleeding through the drain. At the emergent laparotomy, a large thrombotic mass was found in the upper abdomen but there was no active bleeding.
On the 14th postoperative day, similar bleeding occurred again. As angiographic examination revealed a pseudoaneurysm of the right hepatic artery which ruptured toward the choledochojejunostomy, she underwent transarterial embolization. Four weeks after the first operation, she suffered from frequent hematoemesis. Radiologic examination revealed that the pseudoaneurysm was still viable. Re-embolization was abandoned because it was supplied not only from the recanalized right hepatic artery but also from the left hepatic artery. The aneurysm was ligated proximally and distally and resected, and the broken choledochojejunostomy was repaired.