Mycotic aneurysm of the hepatic artery causing haemobilia

Fong, Kang Ler; Zwierzchoniewska, Monika; Patel, Dhruv; Mou, Linjun; Delrivière, Luc

doi:10.1111/ans.13351

Cited by 5 publications

(3 citation statements)

References 7 publications

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“… Unknown, degenerative Unknown No Common HA, proper HA and GDA (Left HA originated from the left GA) Surgical Right PV embolisation for left liver hypertrophy followed by resection of the aneurysm without initially planned right hepatectomy None None 2017 Bacalbasa 23 66 M Unknown, degenerative Unknown Yes Right HA Endovascular Embolisation: polyvinyl alcohol particles, gelaspone and detachable spirals Pancreatitis and retrograde filling of HAA and PV rupture 3 weeks Open resection HAA and segment of PV with roux and Y, complicated by abscess subhepatic which was drained 3 months 2018 Delgado 24 65 M Endocarditis “Small” No Right HA Endovascular Embolisation: n.s. None None 2018 Fong 25 34 F Endocarditis 2.8 Yes Right HA Endovascular Embolisation: coils and thrombin None None 2018 Warren 26 53 F Endocarditis 1.8 Yes Right HA Endovascular Embolisation: coils None 4 days 2019 Das 27 72 F Unknown Unknown Yes Right HA Endovascular Embolisation: coils None None 2019 Zhu 28 28 F Endocarditis 30 No Proper HA and left HA …”

Section: Resultsmentioning

confidence: 99%

Unsuccessful Stent Graft Repair of a Hepatic Artery Aneurysm Presenting with Haemobilia: Case Report and Comprehensive Literature Review

Gao

Jonge

Verhagen

et al. 2021

EJVES Vascular Forum

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Aims To discuss treatment strategies for non-traumatic, non-iatrogenic hepatic artery aneurysms (HAAs) in the presence of an arteriobiliary fistula, illustrated by a case and followed by a comprehensive review of the literature. Methods Following the PRISMA guidelines, 24 eligible HAA cases presenting with haemobilia were identified. Characteristics of patients, aneurysms, treatment strategies and their outcomes were collected. Results A 69 year old patient with no previous hepatobiliary intervention or trauma, presented with jaundice and haemobilia caused by a HAA. Initial treatment by endovascular stenting was chosen to prevent ischaemic liver complications. Unfortunately, this strategy failed because of stent migration due to ongoing infection leading to a type 1A endoleak. The patient had to be converted to open surgery with ligation of the HAA. The patient recovered uneventfully and no complications occurred during the following 12 months. Comprehensive literature review Of the 24 cases, nine had a true HAA and 15 were pseudo/mycotic aneurysms, mainly caused by endocarditis or cholecystitis. The majority were located in the right hepatic artery. In 20 cases, an endovascular first approach was chosen with embolisation, none with covered stents. Three of these cases had to be converted to open surgery because of rebleeding. In all open (primary or secondary) cases, ligation of the HAA was performed. One patient in these series died. No liver ischaemia or abscesses were reported, although one patient developed an ischaemic gallbladder. Conclusions Patients who present with a HAA and haemobilia may be treated safely by embolisation or open ligation. Using a covered stent graft in these patients can cause problems due to ongoing infection and should be monitored closely by imaging. Publication bias and lack of long term follow up imply cautious interpretation of these findings.

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Section: Resultsmentioning

confidence: 99%

Unsuccessful Stent Graft Repair of a Hepatic Artery Aneurysm Presenting with Haemobilia: Case Report and Comprehensive Literature Review

Gao

Jonge

Verhagen

et al. 2021

EJVES Vascular Forum

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“…[5][6][7][8] A few cases of hemobilia that were caused by aneurysmal disease of the artery have also been reported. 1,[9][10][11] However, cases of hemobilia that were caused by mycotic hepatic artery aneurysm have rarely been reported because of low morbidity. 12 Mycotic aneurysm is a rare complication, which is characterized by the presence of septic emboli associated by bacterial endocarditis.…”

Section: Discussionmentioning

confidence: 99%

“…Cases of mycotic hepatic artery aneurysms have rarely been observed or reported owing to the widespread use of effective antibiotics to treat this disease. 1,2 These aneurysms represent a complication of bacterial endocarditis, which possesses a high probability of causing rupture of the artery, leading to hemobilia. To the best of our knowledge, there is no specific technique to manage this condition.…”

Section: Introductionmentioning

confidence: 99%

Massive hemobilia due to a ruptured mycotic hepatic artery aneurysm associated with streptococcal endocarditis: case report

et al. 2019

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Hepatic artery aneurysm rupture is a rare cause of massive hemobilia, which is potentially life-threatening, cause of upper gastrointestinal hemorrhage. Cases of mycotic hepatic artery aneurysm associated with streptococcal endocarditis have rarely been reported. In the present study, we report a case of massive hemobilia that was caused by ruptured mycotic hepatic artery aneurysm in a patient who was infected with streptococcal endocarditis 3 months previously. Transarterial embolization in the patient failed, possibly due to vascular variations. However, surgical treatment was successfully performed, and the patient completely recovered. In conclusion, surgical treatment may be useful in treating massive hemobilia under life-threatening conditions, even in cases of vascular variations and failure of transarterial embolization.

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Hepatic Artery Aneurysms in Infective Endocarditis: Report of 10 Cases and Literature Review

Boukobza,

Ilic-Habensus,

Arregle

et al. 2024

Annals of Vascular Surgery

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Mycotic aneurysm of the hepatic artery causing haemobilia

Cited by 5 publications

References 7 publications

Unsuccessful Stent Graft Repair of a Hepatic Artery Aneurysm Presenting with Haemobilia: Case Report and Comprehensive Literature Review

Unsuccessful Stent Graft Repair of a Hepatic Artery Aneurysm Presenting with Haemobilia: Case Report and Comprehensive Literature Review

Massive hemobilia due to a ruptured mycotic hepatic artery aneurysm associated with streptococcal endocarditis: case report

Hepatic Artery Aneurysms in Infective Endocarditis: Report of 10 Cases and Literature Review

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