Digestive Haemorrhage Revealing a Pseudoaneurysm of the Right Hepatic Artery: A Case Report

Abstract

Introduction: Hepatic artery aneurysms (HAA) are rare and account for 20% of all visceral artery aneurysms. Hepatic artery aneurysms are often discovered at autopsy, but their rupture and bleeding cause significant morbidity and may manifest as haemobilia. Here we report a case of idiopathic right hepatic artery pseudoaneurysm revealed by upper GI bleeding. Presentation: A 72 year old Moroccan woman presented to the emergency department with an upper GI bleed with haematemesis and melaena without any evidence of jaundice. She was admitted with pre-shock haemorrhage and the initial management required early resuscitation measures he turned out to have a pseudoaneurysm of one of the branches of the right subhepatic artery. The aetiology of the pseudoaneurysm was atherosclerosis. The patient underwent radioembolization, the aftermath of which was uncomplicated. Clinical Discussion: Hepatic artery aneurysms (HAA) is a rare cause of gastrointestinal haemorrhage, the management of which requires resuscitative measures Atherosclerosis is the main cause of formation, but it may be associated with connective tissue disorders and arteritis. Most Hepatic artery aneurysms (AAA) are asymptomatic. Aneurysms can be managed by surgical or endovascular interventions. Conclusion: Digestive haemorrhage may reveal a pseudoaneurysm of the right hepatic artery by rupture or fissure in the biliary system. Knowledge on this subject is important for emergency doctors, resuscitators, gastroenterologists, vascular surgeons and hepatobiliary surgeons for the diagnosis and early intervention of this rare entity.