Hepatic artery aneurysm: an unusual cause of upper gastrointestinal bleed

Abstract

An 86-year-old woman presented to hospital with melaena. This was her third presentation with the same symptom. There was no obvious source of bleeding on her oesophagogastroduodenoscopy; however, it did show a previously clipped Dieulafoy lesion. CT angiography showed an aneurysm arising from the hepatic artery. Selective coeliac artery angiogram showed aneurysmal dilatation of the distal part of the coeliac trunk and confirmed the presence of the common hepatic artery aneurysm. The aneurysm was coiled by the interventional radiologist. Final angiogram showed good flow through the hepatic artery with obliteration of the inferior patch. The procedure was uncomplicated and the patient was discharged shortly afterwards.

Interventional treatment of a huge hepatic artery aneurysm as an unusual cause of upper gastrointestinal bleeding

“…11 UGI bleeding caused by HAA rupture is rare, but might be a clinically significant cause of UGI bleedings and has been reported. 3,7,8,10 In the previous case reports, HAA was diagnosed on ultrasonography, CT scan, or angiography and endoscopy revealed no significant abnormality, as was the case in our patient. We think that the hidden concealed small rupture or leaking portion can be missed during the endoscopy examination.…”

“…8,9 However, they may present with severe abdominal pain, a mass, hypovolemia secondary to rupture or gastrointestinal bleeding with normal endoscopy. 10 Delay in diagnosis may lead to lifethreatening hemorrhage. Rupture has been reported in 14%-80% of cases, with mortality rates ranging from 21% to 35%.…”

Manejo endovascular de aneurisma arteria hepática común- Endovascular management of common hepatic artery aneurysm

“…Los aneurismas de la arteria hepática suelen ser asintomáticos y se diagnostican accidentalmente. A su vez, éstos pueden presentarse con dolor abdominal, ictericia, masas abdominales o incluso cursar con rotura espontánea (20-30%) con altísima morbimortalidad asociada 1,5,6 .…”

Upper gastrointestinal bleeding due to hepatic artery aneurysm: Case report and literature review

“…Hepatic artery aneurysm (HAA) is an uncommon and generally asymptomatic disease, affecting approximately 0.002% of the population [ 1 ]. Among visceral aneurysms, it is the second most frequent after splenic artery aneurysms [ 2 ].…”