Splenic Artery Transposition Graft Usage for the Supply of the Right Hepatic Artery: A Case Report

Abstract

Hepatic artery aneurysms are responsible for 12% to 20% of all visceral arterial aneurysms. Because most patients are asymptomatic, this disease is generally diagnosed incidentally during radiologic examination. Aneurysm rupture develops in 14% to 80% of cases, depending on the aneurysmatic segment's diameter and location, as well as other etiologic factors. Mortality rates associated with rupture range between 20% and 70%. Thus, early diagnosis and timely initiation of medical interventions are critical to improve survival rates. Here, we present a male patient, age 69 years, with a hepatic artery aneurysm that was detected incidentally. The 3-cm aneurysm was detected on contrastenhanced computed tomography and extended from the common hepatic artery to the hepatic trifurcation. A laparotomy was performed using a right subcostal incision. After dissection of the hepatoduodenal ligament, the common, right, and left hepatic arteries, as well as the gastroduodenal artery, were suspended separately. Then, the aneurysmatic hepatic artery segment was resected, and the gastroduodenal artery stump was ligated. An end-to-end anastomosis was formed between the left and common hepatic arteries, followed by an end-to-end anastomosis formed between the right hepatic artery and splenic artery using a splenic artery transposition graft. Postoperative follow-up examinations showed that both hepatic arterial circulations were good, and no splenic infraction had developed.

Splenic artery transposition for reconstruction of a large hepatic artery aneurysm: A case report and literature review

“…Of these, we believe that the most important advantages of the splenic artery are the adjustable caliber difference and ability to secure sufficient distance. A PubMed search using the keywords “open surgery” and “hepatic artery aneurysm” revealed 15 cases of hepatic artery resection and reconstruction among 10 years from 2011 to 2021, including our own cases ( Table 1 ) [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] . Five cases had autologous arterial reconstruction and four of these five cases had splenic artery transposition.…”