Background : Common hepatic artery(CHA) pseudoaneurysm is a rare entity that occurs after abdominal surgery, intervention, trauma or infection. Spontaneous CHA pseudoaneurysm is even more uncommon condition with high morbidity and mortality.

Methods : We report a case of 70 year old male who was admitted under cardiology for non ST elevation myocardial infarction with left ventricle clot post COVID vaccination. He complained of severe abdominal pain on day 4 of admission. CT abdomen pelvis done showed large common hepatic artery(CHA) aneurysm with hemoperitoneum. There was no active extravasation. We performed diagnostic angiogram, embolization of CHA aneurysm and stenting from celiac origin into splenic artery.

Results : Post operatively, patient developed right brachial artery pseudoaneurysm which required thrombin injection. The access site was further complicated with hematoma and compression of brachial artery and was treated with open repair and drainage. He was discharged well and stable on post-operative day 21.

Conclusions : Spontaneous common hepatic artery pseudoaneurysm is a rare but potentially life threatening condition. Early recognition and management are crucial for favourable outcome. Endovascular approach is a safe and feasible option which mitigates the need for open repair.