The Aftermath of a Hepatic Artery Aneurysm—A Rare Etiology of Biliary Obstruction!

Linzay, Catherine; Seth, Abhishek; Suryawala, Kunal; Sheth, Aakash; Boktor, Moheb; Bienvenu, John; Rahim, Robby; Sangster, Guillermo; Jordan, Paul

doi:10.1177/1179552217711430

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…1 Pseudoaneurysms of the hepatic artery are very rare and usually occur following blunt or penetrating trauma, iatrogenic sequelae of hepatic and biliary procedures, and less commonly due to chronic infection or inflammation. 2 Patients with hepatic pseudoaneurysms can present with abdominal pain, jaundice, melena, and/or a pulsatile mass. Diagnosis usually starts with ultrasound imaging and computed tomography (CT) with the gold standard for the diagnosis being made with angiography.…”

Section: Introductionmentioning

confidence: 99%

An Unusual Cause of an Intraperitoneal Bleed: Bleeding Hepatic Artery Pseudoaneurysm Due to an Eroding Cholecystitis

Sawalha

Kunnumpurath

McCann

2020

Journal of Investigative Medicine High Impact Case Reports

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An 80-year-old male patient presented with sepsis secondary to infected central line which was placed for native aortic valve endocarditis. He also had melena and abdominal pain prior to his presentation. Abdominal computed tomography (CT) was done, which showed cholelithiasis. Esophagogastroduodenoscopy was also done with no source of bleeding identified. Later, he developed hemodynamic instability requiring aggressive fluid resuscitation and multiple packed blood cell transfusions. In view of his hemodynamic instability, a repeat abdominal CT scan showed air droplets within the gallbladder pneumobilia, ascites, diverticulosis, and a bleeding infrahepatic hematoma measuring 6 × 10 cm, which was not on his prior scan 2 days prior. A mesenteric arteriogram was performed that identified an aneurysm of the right hepatic artery with no active bleeding; therefore, it was coiled. Due to his continued clinical decompensation, he underwent an urgent open cholecystectomy, in which serosanguineous fluid, cholecystocolic fistula, and old clot related to his previous bleed were encountered. However, control of bleeding was difficult, and the patient expired. We report this case of right hepatic artery aneurysm that we believe its etiology was related to eroding cholecystitis.

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Section: Introductionmentioning

confidence: 99%

An Unusual Cause of an Intraperitoneal Bleed: Bleeding Hepatic Artery Pseudoaneurysm Due to an Eroding Cholecystitis

Sawalha

Kunnumpurath

McCann

2020

Journal of Investigative Medicine High Impact Case Reports

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“…Methods We present a case of HAA that presented with obstructive jaundice due to exogenous pressure of the biliary tree 1 2 3 4 .…”

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confidence: 99%

A case of obstructive jaundice due to exogenous pressure of the common bile duct from a hepatic artery aneurysm mimicking mirizzi syndrome

Sotiropoulos,

Theocharis,

Thomopoulos

2023

ESGE Days 2023

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Traction-induced aneurysm of an accessory left hepatic artery: a potentially fatal but synchronously treatable complication of a large hiatus hernia

Isola

Jawad

Chua

et al. 2022

annals

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A 59-year-old man presented to our surgical clinic with a long-standing history of heart burn, and upper abdominal pain. Gastroscopy showed a large sliding hiatus hernia associated with severe reflux oesophagitis. Oesophageal pH manometry revealed a high DeMeester score of 36.03. A computed tomography (CT) scan was performed for preoperative hiatal hernia repair planning. This showed the incidental finding of an accessory left hepatic artery (ALHA) and an aneurysm of this accessory artery. The aneurysm occurred at the point where the ALHA traversed the diaphragmatic crus and was only present in association with the hiatus hernia. These observations suggest that the aetiology of the aneurysm was due to traction during development of the hiatus hernia. The patient went onto have a laparoscopic hiatus hernia repair and Toupet fundoplication with ligation of the accessory left hepatic artery and made an excellent recovery. ALHAs are not uncommon, occurring in around 15% of the general population, with aneurysms of the hepatic arteries accounting for about 20% of cases of visceral artery aneurysms. The case presented herein highlights the importance of performing an arterial phase CT when planning surgery for large hiatus hernias to detect more cases like this one. This would allow early detection and concurrent treatment of an associated aneurysm with repair of the hiatus hernia, to prevent aneurysmal complications later on.

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The Aftermath of a Hepatic Artery Aneurysm—A Rare Etiology of Biliary Obstruction!

Cited by 3 publications

References 14 publications

An Unusual Cause of an Intraperitoneal Bleed: Bleeding Hepatic Artery Pseudoaneurysm Due to an Eroding Cholecystitis

An Unusual Cause of an Intraperitoneal Bleed: Bleeding Hepatic Artery Pseudoaneurysm Due to an Eroding Cholecystitis

A case of obstructive jaundice due to exogenous pressure of the common bile duct from a hepatic artery aneurysm mimicking mirizzi syndrome

Traction-induced aneurysm of an accessory left hepatic artery: a potentially fatal but synchronously treatable complication of a large hiatus hernia

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