Hepatic artery aneurysm.

Abstract

Hepatic artery aneurysms (HAAs) are rare. A review of the English language literature from 1985 to 1995 for reports of visceral artery aneurysms showed HAA to be the most frequently reported visceral aneurysm during that decade. This increase in incidence relates to the increasing use of percutaneous diagnostic and therapeutic procedures. A second factor is the increased use of diagnostic CT scanning after blunt liver trauma. The purpose of this pictorial review is to illustrate the imaging presentation and radiological management of HAAs.

A rare cause of an abdominal mass

“…It is the fourth most common site of intraabdominal aneurysm due to any cause following infrarenal aorta, iliac and splenic arteries [1]. True HAA's are rare; 80% are extra hepatic, of which 63% affect the common hepatic artery [4], 5% the left hepatic artery and 4% the left and the right hepatic arteries; lesions being single or multiple [1,2]. Usually men are affected (65 % cases); the average age of presentation being 38 years.…”

“…Other causes include congenital [5], iatrogenic (hepatic artery catheterization, hepatic tumor embolisation, anastomotic complication of orthotopic liver transplantation) [2], arterial medial degeneration, fi bromuscular dysplasia, arteritis, collagen vascular disease, infections [6] and periarterial infl ammation caused by cholecystitis or pancreatitis and rarely by narcotizing vasculitides [2,7,8].…”

“…The type of aneurysm also has an important role in deciding the management. Saccular aneurysm requires aneurysmorrhaphy or patch angioplasty, whereas true aneurysms may require ligation and/or reconstruction of the hepatic artery [2]. Giant HAA's may be managed either by surgery or embolisation, unless, bilioenteric bypass is to be created to resolve jaundice or to restore blood supply to the ischaemic liver [14].…”

“…[1,2]. Although the condition is most frequently discovered as an incidental fi nding at autopsy, awareness of this condition is important as there is a high probability of these aneurysms rupturing and presenting as acute abdomen.…”

Hepatic artery aneurysm: incidental diagnosis with abdominal ultrasonography and treatment by coil embolization

“…Other causes include mycotic aneurysms, trauma, polyarteritis nodosa, pancreatitis, liver transplantation, neurofibromatosis, Wegener granulomatosis, and tuberculosis 4 . Currently HAA is the most frequently visceral artery aneurysm and is probably related to the increasing use of percutaneous diagnostic and therapeutic procedures 5 . The widespread use of ultrasonography (US) and computed tomography (CT) has led to increased detection of asymptomatic aneurysms.…”