Pseudoaneurysms are vascular lesions that develop from the rupture of the intimal and medial layers of the arterial wall and consequently do not contain any epithelialized wall. This allows differentiation from true aneurysms, which, in contrast, retain all three layers of the vascular wall. Abdominal visceral pseudoaneurysms arise from splanchnic circulation and renal arteries [2].

Among abdominal visceral pseudoaneurysms, eHAPAs represent a considerable proportion, with an incidence of  3.4 - 4%; they are a condition often resulting from iatrogenic injury, liver trauma, and acute or chronic severe pancreatitis. Unlike true aneurysms, they tend to manifest symptoms such as gastrointestinal bleeding or hemobilia. They are a potentially life-threatening condition due to potential haemorrhage and so must be treated as soon as the diagnosis is made, whether they are symptomatic or not. Size has not been correlated with higher rupture risk [1, 3].

Both open and endovascular approaches are viable options for repairing eHAPAs. The long-term outcome after repair is similar between the open and endovascular approach but morbidity is worse in the open approach. Due to the lower rate of major complications and reduced hospitalisation, endovascular repair is often the preferred choice.

The choice between open and endovascular repair of eHAPAs should fall on the technique that best maintains liver circulation  [3, 4, 5].