Delayed bleeding complication due to internal mammary artery injury after ultrasound‐guided percutaneous catheter drainage for liver cyst infection

Background Ultrasound‐guided percutaneous catheter drainage (PCD) is widely accepted as a primary treatment for pyogenic liver abscess. Severe PCD‐related complications have been reported; however, delayed bleeding complications due to internal mammary artery injury are unknown. Case Presentation An 84‐year‐old man undergoing hemodialysis owing to chronic kidney disease due to focal segmental glomerulosclerosis was admitted to our hospital for liver cyst infection. Ultrasound‐guided PCD was carried out through the normal liver at the upper abdominal midline at the level of the sixth intercostal space. Two days later, an abdominal hematoma occurred at the puncture site. Contrast‐enhanced computed tomography revealed extravasation of the distal right internal mammary artery, which was successfully treated with percutaneous coil embolization. Conclusion Internal mammary artery injury should be considered as a differential diagnosis when a progressing hematoma develops after PCD. Contrast computed tomography which performed after the percutaneous catheter drainage indicated extravasation of the right internal mammary artery.