Contained rupture of a large right hepatic artery aneurysm: the ticking bomb within!

Hepatic artery aneurysms (HAAs) are rare and represents one fifth of visceral aneurysms. We report a case of a 75 year old female who presented to the outpatient department with complaints of abdominal pain and anorexia for 2 weeks. On examination the patient was stable, she had mild tenderness in the right hypochondrial region. Ultrasound abdomen showed an intrahepatic cystic area with both arterial and venous flow, suggesting the possibility of an intrahepatic arteriovenous malformation. Contrast-enhanced computed tomography abdomen showed a large right HAA with contained rupture and intra hepatic extension. She was posted for emergency laparotomy and was found to have a contained rupture a contained rupture of the right HAA of size 10×8 cm with intra hepatic extension. Right hepatectomy was done and the resected margin of liver showed a dilated cystic space with blood clot. Histopathological examination showed intrahepatic aneurysm with atherosclerosis and laminated luminal thrombus. Contained rupture of HAAs with intrahepatic extension are rare. Even though the prevalence of HAAs is low, the risk of rupture is reported to be as high as 20-80% and the mortality following spontaneous rupture is 40%. Hence an aggressive approach to the management of HAA is required whenever detected.

A Case of Common Hepatic Artery Aneurysm Treated by Abdominal Aorta—Proper Hepatic Artery Bypass and Coil Embolization— / 日本心臓血管外科学会雑誌

A 52-year-old man underwent a medical examination, including abdominal computed tomography (CT). Abdominal CT revealed a common hepatic artery aneurysm (25 mm in diameter) ; a portion of the aneurysm depressed the pancreas. The gastroduodenal artery branched off the common hepatic artery aneurysm. We planned coil embolization for the common hepatic artery aneurysm. However, we could not avoid occluding the proper hepatic artery ; therefore, we performed abdominal aortic-proper hepatic artery bypass with coil embolization. The patient's postoperative course was uneventful.

Hemobilia secundaria a aneurisma de la arteria hepática / Hemobilia Secondary to Aneurysm of the Hepatic Artery

Resumen Se presenta el caso de un paciente con hemorragia de vías digestivas altas e ictericia asociadas a un aneurisma de la arteria hepática derecha.

Abstract We present the case of a patient with upper digestive tract hemorrhaging and jaundice due to an aneurysm of the right hepatic artery.

Giant Hepatic Artery Aneurysm Associated with Immunoglobulin G4-Related Disease Successfully Treated Using a Liquid Embolic Agent

No abstract available.

Hepatic Artery Pseudoaneurysm Associated with Plastic Biliary Stent

The increased use of interventional procedures and laparoscopic cholecystectomy in the management of hepatobiliary disorders is associated with an increased incidence of hemobilia and hepatic artery aneurysm. Here we report a case of hepatic artery pseudoaneurysm associated with a plastic biliary stent. Multiple factors were involved in the formation of the hepatic artery aneurysm (HAA) and it was successfully treated by embolization.

Multiple Arterial Aneurysms in Cerebral Palsy Patient

A 36-year-old man presented abrupt onset of epigastric pain with high fever for one week after pork meal. Extensive diagnostic studies including blood, urine and stool cultures and other inflammatory factors were done but only leukocytosis, 1:160 for H Ag of widal test, and increased FDP were positive findings. Abdominal CT showed multifocal hepatic and splenic arterial aneurysms which grew very rapidly during these 10 days. Emergency exploration and ligation at either side of common hepatic artery and the proximal segment of right hepatic artery were done because of impending rupture. The histologic findings of the excised aneurysmal wall were diffuse infiltration of inflammatory cells and medial necrosis. Several other arterial aneurysms at right brachial, left carotid and branch of superior mesenteric artery were identified on the follow up angiogram. Also noted right brachial artery thrombosis in aneurysmal dilatation site and this was treated by continuous intraarterial infusion of urokinase. Even though the patient had no endocarditis and no growth of blood culture, we consider this multiple artery aneurysms as an infected aneurysm by unknown bacteremia due to pork meal.