TITLE:
Hepatic Artery Aneurysm: An Unusual Cause of Upper Gastrointestinal Bleed in 49 Years Old Patient
AUTHORS:
Salamata Diallo, Alioune Badara Fall, Mamadou Lamine Gueye, Marie Louise Bassene, Mamadou Ngoné Gueye, Marieme Polele Fall, Mame Aissé Thioubou, Alsine Yauck
KEYWORDS:
Hepatic Artery Aneurysm, Rupture, Upper GI Bleeding, Surgery
JOURNAL NAME:
Open Journal of Gastroenterology,
Vol.12 No.3,
March
17,
2022
ABSTRACT: Hepatic artery aneurysm (HAA) is a rare disease. HAA is generally
asymptomatic disease when symptomatic, they usually present with abdominal
pain, upper gastrointestinal (GI) bleeding and/or jaundice, hypovolaemia
secondary to rupture or GI bleeding with normal GI endoscopy. Surgical repair
and endovascular treatment are the two therapeutic options available at
present. Case report: A 49-year-old male presented at the emergency
department with high gastrointestinal bleeding, abdominal pain and jaundice.
Gastroscopy showed an ulcer with flat pigmented haematin on ulcer base (Forrest
IIc) that was controlled by medical treatment. CT angiography was done and
showed aneurysm of the proper hepatic artery almost totally thrombosed
measuring 100 × 59 mm associated with signs of contained rupture. Emergency
surgery was indicated. The laparotomy objectified a rupture of the aneurysm in
the biliary tree in per operative excision of aneurysm and ligation of the
hepatic pedicle was carried out. After surgery, the evolution was favorable
with a follow-up of 8 months. Conclusion: HAA rupture is a rare cause of
upper GI bleeding. The mortality rate after rupture is relatively high. CT
angiography or MRI can diagnose a ruptured of HAA. Urgent surgery should be the
first choice in patients with a ruptured HAA with active hemorrhage causing
hemorrhagic shock.