Management options for hepatic artery aneurysms.

A 70-year-old woman underwent an elective sigmoid resection for chronic diverticulitis. On the third postoperative day she suddenly developed abdominal pain and hypotension after a coughing episode. Radiologic evaluation demonstrated the presence of a hemoperitoneum. A celiac arteriogram was obtained in an effort to determine the cause of the hemorrhage. Four aneurysms of the intrahepatic portions of the left and right hepatic arteries were found. These aneurysms were successfully treated using steel coil embolization. Surgery has traditionally been the "gold standard" treatment of this rare entity. Recent reports have demonstrated the utility of embolization in treating aneurysms of the hepatic arteries. This report reviews the current treatment options available in the management of hepatic artery aneurysms. Embolization of the aneurysms is recommended.

Traumatic pseudoaneurysm in a wrestler.

An 18-year-old man sought treatment for a pulsatile mass in the medial distal thigh four years after he had sustained blunt trauma during a wrestling match. Investigation, which included magnetic resonance imaging and arteriography, showed the mass to be a pseudoaneurysm, which should be considered in the differential diagnosis of masses resulting from direct, blunt trauma. At exploration, a pseudoaneurysmic thrombus in the superficial femoral artery was evacuated and the vessel was repaired with an interposition graft of reversed saphenous vein, followed by complete recovery of the patient.