Hepatic artery aneurysm: Imaging findings Hepatik arter anevrizması: görüntüleme bulguları

Abstract

Hepatic artery aneurysm is uncommon with an estimated incidence of less than 0.25%. Because most patients are asymptomatic, the diagnosis is usually made as an incidental finding on imaging studies performed for other reasons. Because of their propensity to rupture with potential catastrophic intraperitoneal hemorrhage, early diognosis is important. Herein, relatively asymptomatic two aneurysms of the hepatic artery of atherosclerotic etiology is presented. The importance of imaging findings in the diagnosis of this condition is discussed and relevant literature is reviewed.Key words: Hepatic artery aneurysm, computed tomography, angiographyHepatik arter anevrizmaları ender olup, insidansı % 0.25'den daha azdır. Hastaların çoğu asemptomatik olduğu için tanı genellikle başka nedenlerle yapılan görüntüleme tetkikleri sırasında tesadüfen konulur. Hepatik arter anevrizmaları, potansiyel katastrofik intraperitoneal kanamayla rüptüre olmaya eğilimli oldukları için erken tanı önemlidir. Burada, etyolojisinde aterosklerozun rol oynadığı iki adet HAA'sı bulunan bir olgu sunulmaktadır. Tanıda görüntüleme bulgularının önemi tartışılmış ve ilgili literaür gözden geçirilmiştir.Anahtar kelimeler: Hepatik arter anevrizması, bilgisayarlı tomografi, anjiografi T he hepatic artery is the fourth common site of intraabdominal aneurysm from any cause following infrarenal aorta, iliac artery and splenic artery (1,2). Hepatic artery aneurysm (HAA) represent approximately 20% of all visceral aneurysms (3). 80% HAAs are extrahepatic and 20% are intrahepatic. 63% of HAAs involve the common hepatic artery, 28% involve the right hepatic artery, 5% involve the left hepatic artery, and 4% both the left and right hepatic arteries (1,2). Case reportA 53 year-old female patient presented with 6-month history of right upper abdominal pain. The physical examination was unremarkable. Routine hematological and biochemical profiles were normal.Gray scale abdominal ultrasonography revealed two well-defined, rounded cystic masses measuring 20 mm and 10 mm in diameter in the region of the porta hepatis.Doppler sonography, performed to evaluate the vascularity associated with the lesions revealed pulstatile flow within the lesions with a vascular origin. The findings suggested HAA and helical computed tomography (CT) was subsequently performed. Unenhanced CT scan showed two well-circumscribed lesions at the porta hepatis (Figure 1a, 1b). After intravenous administration of 100 ml. of bolus of contrast medium and scanning in early arterial phase (15-Corresponding Author